Should UNOS Address the Regional Disparities in Kidney Allocation?

I live in Southern California. I was told at my last annual transplant evaluation that if I wanted a standard kidney (KDPI between 21 and 85) that I could expect to wait two to three more years for a total wait of 8 1/2 to 9 1/2 years for type A blood, no antibodies. The doctor wanted me to accept an extended criteria kidney (KDPI 85-100). This type of kidney is expected to last 5 years. Since at my age (69) and in good health aside from my kidney problems, I think my life expectancy is more than 5 years, I declined the extended criteria kidney.

My insurance will not pay for me to have a transplant outside of Southern California. I know from my research on the internet that people living in nearby states (and in other areas across the country) do not wait 8 1/2 to 9 1/2 years for a kidney with type A blood, no antibodies. How is this fair?

In 2014, UNOS changed the kidney allocation process to try and correct the disparity in wait times for people with type B blood and to better age-match kidneys to their recipients. While I think this was in general, a positive step, I also think it created the consequence of age discrimination (but that is the subject of a different rant). I think UNOS needs to address the discrepancies in wait times between different areas of the country and develop a more equitable distribution system. What do you think?