A review of utility-based allocation strategies to maximize graft years of deceased donor kidneys.
With the continuing shortage of deceased donor kidneys coupled with a growing number of older potential recipients, there has been a greater acceptance of using older donor kidneys, including increased utility of expanded criteria donor (ECD) kidneys. In this review, we will look at the impact of using ECD kidneys on graft and patient survival, and to identify modifiable factors that may improve transplant outcomes in recipients receiving ECD kidneys. In addition, we will discuss whether the implementation of utility-based allocation strategies to maximize graft outcomes is an appropriate way forward to provide a better balance between utility and equity in the distribution of deceased donor kidneys.
Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia. wai.lim@health.wa.gov.au
Wai H
WH
Lim
Steve
S
Chadban
Scott
S
Campbell
Solomon
S
Cohney
Graeme
G
Russ
Stephen
S
McDonald
D001315:Australia; D046148:Donor Selection / Q000706:statistics & numerical data*; D006085:Graft Survival; D006297:Health Services Accessibility; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D009520:New Zealand; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data*; D016896:Treatment Outcome