title: Impact of the new fast track kidney allocation scheme for declined kidneys in the United Kingdom.
abstract: BACKGROUND
  A "new" fast track kidney allocation scheme (FTKAS) was implemented in the UK in 2012 for offering of previously declined kidneys. We evaluated the impact of the FTKAS in utilization of declined kidneys and outcome.
  
  
  METHODS
  Adult renal transplant centers were surveyed. Overall utilization was evaluated using National Health Service Blood and Transplant (NHSBT) data. Outcome of FTKAS kidneys in our center was analyzed.
  
  
  RESULTS
  Centers cited graft, patient outcome concerns, and inadequate logistical support for their non-FTKAS participation. In the first year of the scheme, 266 kidneys were offered through the FTKAS, 158 were transplanted in 10 centers (59%). In comparison, 166 kidneys were offered through previous system over five yr (2006-2011), and 65 were utilized in 59 transplants (39%). In our center, 42 kidneys were transplanted in 39 recipients. One-yr graft and patient survival were both 95%. Results were comparable to a matched group of kidney transplants during the same periods allocated via the standard scheme.
  
  
  CONCLUSIONS
  The FTKAS has led to effective utilization of the declined kidneys with outcome comparable to kidneys allocated through the standard scheme. Non-participation based on outcome concerns is mostly subjective while logistical issues need to be addressed.
authors.affiliation: Division of Surgery, Department of Transplantation, St James' University Hospital, Leeds, UK.
authors.forename: Alan D
authors.initials: AD
authors.lastname: White
authors.affiliation: Division of Surgery, Department of Transplantation, St James' University Hospital, Leeds, UK.
authors.forename: Heather
authors.initials: H
authors.lastname: Roberts
authors.affiliation: Division of Surgery, Department of Transplantation, St James' University Hospital, Leeds, UK.
authors.forename: Clare
authors.initials: C
authors.lastname: Ecuyer
authors.affiliation: Division of Surgery, Department of Transplantation, St James' University Hospital, Leeds, UK.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Brady
authors.affiliation: Division of Surgery, Department of Transplantation, St James' University Hospital, Leeds, UK.
authors.forename: Samir
authors.initials: S
authors.lastname: Pathak
authors.affiliation: Department of Histocompatibility and Immunogenetics, St James' University Hospital, Leeds, UK.
authors.forename: Brendan
authors.initials: B
authors.lastname: Clark
authors.affiliation: Division of Surgery, Department of Transplantation, St James' University Hospital, Leeds, UK.
authors.forename: Lutz H
authors.initials: LH
authors.lastname: Hostert
authors.affiliation: Division of Surgery, Department of Transplantation, St James' University Hospital, Leeds, UK.
authors.forename: Magdy S
authors.initials: MS
authors.lastname: Attia
authors.affiliation: Department of Renal Medicine, St James' University Hospital, Leeds, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Wellberry-Smith
authors.affiliation: National Health Service Blood and Transplant, Bristol, UK.
authors.forename: Alex
authors.initials: A
authors.lastname: Hudson
authors.affiliation: Division of Surgery, Department of Transplantation, St James' University Hospital, Leeds, UK.
authors.forename: Niaz
authors.initials: N
authors.lastname: Ahmad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D046148:Donor Selection / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies; D013997:Time Factors; D006113:United Kingdom
keywords: allocation; declined; discarded; donation after brain death; donation after circulatory death; fast track; kidney; outcome; transplant