James V. DeLong, in "How to close the `organ' gap" (Commentary, Oct. 14), concludes that the system for allocating donor organs for transplantations needs to be improved. He suggests that preferences of the individual donor and the economic motivation be considered.

In fact, the donor families can direct organ donation to either a certain person or to a certain facility, depending on their wishes. This is something that is not widely done but probably deserves more publicity in this time of great organ shortages.

The issue about economic motivation obviously is intriguing and important. As stated in the editorial, transplantation is predicated on the economic prosperity that it brings to the transplant centers. Therefore, to consider some way of offering incentives in the donor process is a good idea. One consideration is that the transplant institution pay for funeral costs associated with the donor's burial.

There is widespread rancor among different transplant centers concerning how to allocate organs. In Illinois, there are 36 different organ transplant programs. Because the system is supposed to be patient-driven, I would propose that patients on transplant center waiting lists be listed for an organ in their home state. This would allow for transplant programs to obtain donors from the home state of the patient.

Loyola University, because of the national prominence of our liver transplantation medical director, sees patients from many other states. If we could list these patients in their home states and then procure the liver from that state to transplant them, it would not deprive a citizen in the state of Illinois from receiving a liver that may go to these out-of-state patients. It would allow all patients better access to livers and would allow the large and successful program to continue to be successful. Many times potential recipients are turned down at the local or regional program because they are considered too sick and too difficult to transplant. Therefore, they end up at a national program that has a tradition for doing the difficult transplants. If these patients could be listed in their home state, it would be a much fairer system and would not penalize patients in the state in which the national program is located.

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