The organ supply chain: Geography and the inequalities of transplant logistics,Transactions of the Institute of British Geographers

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The organ supply chain: Geography and the inequalities of transplant logistics
Transactions of the Institute of British Geographers ( IF 3.3 ) Pub Date : 2021-04-20 , DOI: 10.1111/tran.12458
Harrison Cole ₁

Affiliation

This paper describes how supply chain management practices are applied to the process of organ transplantation in the USA. While these practices are meant to increase the volume of organs available for transplantation, I argue that they may in fact exacerbate existing inequities of access to treatment. This is an especially pressing issue given that the number of people currently on the organ transplant waiting list far exceeds the number of organs available for transplantation, a situation referred to as the organ shortage crisis. A contributing factor to this disparity is the spatiotemporal distribution of transplant centres, donors, and recipients, considering that the transplant process is so time-sensitive and time-intensive. In response, the healthcare industry is developing systems that smooth and accelerate the procurement and delivery of organs, creating a logistical network that is standardised, data-driven, and able to be deployed at a moment’s notice. However, these new systems draw design inspiration from those originally developed for profit-based corporate supply chains, and thus risk employing the spatial logics of corporate supply chain management practices. Drawing from interviews with transplant and other medical professionals, I argue that applying these practices to the organ transplant network may end up privileging already-advantaged patients, when instead, a truly equitable network must attend to the uneven landscape of transplantation in the USA. Furthermore, I argue that these technologies should not necessarily be resisted outright, but rather adopted in the interest of universal access as opposed to the maintenance of profitability.

中文翻译：

器官供应链：地理和移植物流的不平等

本文描述了供应链管理实践如何应用于美国的器官移植过程。虽然这些做法旨在增加可用于移植的器官数量，但我认为它们实际上可能会加剧现有的治疗不公平现象。这是一个特别紧迫的问题，因为目前器官移植等候名单上的人数远远超过可供移植的器官数量，这种情况被称为器官短缺危机. 考虑到移植过程对时间非常敏感和时间密集，造成这种差异的一个因素是移植中心、捐赠者和接受者的时空分布。作为回应，医疗保健行业正在开发能够顺畅和加速器官采购和交付的系统，创建一个标准化、数据驱动且能够在接到通知后立即部署的物流网络。然而，这些新系统从最初为基于利润的企业供应链开发的系统中汲取设计灵感，因此存在使用企业供应链管理实践的空间逻辑的风险。通过对移植和其他医疗专业人员的采访，我认为将这些做法应用于器官移植网络可能最终会使已经处于优势的患者享有特权，相反，一个真正公平的网络必须关注美国不平衡的移植环境。此外，我认为这些技术不一定应该被彻底抵制，而是为了普遍获取而不是维持盈利能力而采用这些技术。

更新日期：2021-04-20

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