Deceased Donor: Kidney Allocation Policy

By Anna Bennett

The facts are clear.  There are not enough kidneys for those who want to be transplanted and the "List" is overinflated.  See Bill's post Waiting for a Transplant - eligible v. ineligible.

In the past few years, there have been inroads in dialysis (NxStage and HDHH) and inroads in transplantation.  New immunosurpressives are doing amazingly well with low antigen match kidneys.  OPTN/ UNOS are in the process of changing the current kidney allocation criteria.  Back in September, OPTN/UNOS issued a request to the community for input. 

Bill posted about this request in Measuring Dialysis to fairly allocate kidneys for transplant .  He wrote about his concern with regard to qualifying dialysis yet not differentiating between the superior outcomes of High Dose Home Hemodialysis v. standard in center hemodialysis.

The Renal Support Network has posted their response to the proposed OTPN/UNOS Kidney Allocation Policy.  

In the final paragraphs of RSN's response, they have a wise, reasonable request:

Thousands of lives will be affected. So we ask that OPTN/UNOS allow ongoing conversation and input prior to a decision, that a final process be more simplified and readily comprehendible than that which is currently proposed and that a pilot program be considered. This will help understand the impact and allow for changes if the new system needs adjusting.

Watching the development of redefining the allocation process is an amazing window into healthcare reform.