United Network for Organ Sharing (UNOS) Kidney Transplant Committee Update
January 03, 2012 |
Research & Medicine
Concepts Proposed to change current policy
• Utilize a kidney donor profile index (KDPI) to better characterize donor kidneys and to provide additional clinical information for patients and providers to consider during the transplant evaluation process and organ offer process.
• Allocate the majority of organs (80%) by age matching so that candidates within 15 years (older and younger) of the donor are prioritized.
• Allocate some kidneys (20%) by a kidney donor profile index (KPDI) and estimated recipient post-transplant survival.
Feedback received from public comments
• General agreement with longevity matching for some kidneys
• Concerns over use of age matching (+/-15 years)
• Support for use of KDPI as a clinical tool and in allocation
Based on public feedback, the Kidney Transplant Committee deciding that age matching would be dropped.
Highlights of current working model
• Allocation based on longevity of graft matching to expected recipient longevity is accepted and sustains legal scrutiny.
• The majority of kidneys are still allocated very similarly to current rules.
• Waiting time remains the primary determinant of kidney allocation
• Improve “Extended Criteria Donor” system addresses concerns of older recipients
• “Opt in” to longevity matching preserves recipient choice
• This choice allows trade off of a kidney with more longevity for more rapid transplantation
• Regional allocation might improve recovery and placement
• Allocation on time alone makes it makes it predictable and allows list management.