Matching graft to recipient by predicted survival: can this be an acceptable strategy to improve utilization of deceased donor kidneys?
A new kidney allocation scheme is needed to address the current shortage of deceased donor kidneys for transplantation in the United States. With this goal in mind, we have derived a novel utility-based system to balance supply and demand. Our system uses a North American-based recipient risk score and the deceased donor score to maximize the total number of years of renal allograft function as a means to improve allocation of kidneys from deceased donors. Essentially, donor renal allografts are matched to a wait-listed candidate with similar predicted survival, which poses an ethical issue. However, this novel utility-based system is practical and could improve deceased donor renal allocation by minimizing both waste and need for retransplantation.
Baskin-Bey
Edwina S
ES
Division of Transplantation Surgery, William J. von Liebig Transplant Center, Mayo Clinic, Rochester, MN 55905, USA.
Nyberg
Scott L
SL
D002102:Cadaver; D018572:Disease-Free Survival; D006085:Graft Survival; D015276:Health Care Rationing / Q000941:ethics / Q000379:methods*; D006801:Humans; D016030:Kidney Transplantation; D011379:Prognosis; D018570:Risk Assessment; D014019:Tissue Donors; D014184:Transplantation, Homologous; D014850:Waiting Lists