UNOS: Kidney Allocation Policy Development - feedback requested

[okarol]

Kidney Allocation Policy Development

Background

The current kidney allocation system has been in place for over 20 years. During this time, some changes have been made, but the system cannot keep up with current trends in medicine. As waiting times for kidney transplant increase throughout the United States, the need for review of the current system and discussion of possible revisions is great.

Under consideration

The OPTN/UNOS Kidney Transplantation Committee considered many concepts and approaches to allocation over five years.

In a continuing effort to improve the national kidney allocation system, the OPTN/UNOS Kidney Transplantation Committee requests feedback from the transplant community and the public on three proposed concepts for allocation. These concepts were developed in response to feedback provided during a public forum held in January 2009.

The committee requests that transplant professionals, candidates, recipients and the public review the concept document and provide feedback by e-mailing kidneypolicy@unos.org. Comments will be accepted through April 1, 2011.

More info go to http://optn.transplant.hrsa.gov/kars.asp

[Stoday]

Proposed new allocation priorities:

1. Utilizing 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. The KPDI is a continuous scale for measuring kidney quality to estimate the potential function of a donated kidney if it were transplanted in to the average recipient.

2. Allocating the highest quality kidneys (KDPI 20% and below) to the candidates with the highest estimated post-transplant survival (EPTS). Such kidneys account for 20% of available kidneys at this time.

3. Allocating remaining kidneys (80%) such that candidates have highest priority who are within 15 years (older or younger) of the donor’s age.

The phrase "candidates with the highest estimated post-transplant survival" is ambiguous. Does it mean candidates who are least likely to drop dead or candidates whose kidneys are least likely to fail?