UNOS Proposal Seeks to Improve Kidney Transplant Allocation

Northwestern Medicine
Organ Donation and Transplantation September 24, 2012

John Friedewald, MDJohn Friedewald, MD, a transplant nephrologist at Northwestern Memorial Hospital, is Chair of the UNOS Kidney Committee sponsoring a new kidney transplant allocation proposal.

After nearly eight years of research, policy development, and consensus building, the United Network for Organ Sharing (UNOS) Kidney Committee released a new kidney allocation policy proposal this past Friday. The series of improvements to the system aim to enhance the long-term benefit of kidney transplantation, make better use of available kidneys, and increase transplant opportunities for hard-to-match candidates. 

Although the current kidney allocation system has many positive features, we realize that we can improve the way we allocate donor kidneys in order to make the most of a valuable and scarce resource.  One highlight of the proposal would be the use of longevity matching, in which kidneys predicted to function a long time would be allocated to recipients that are likely to live for a long time with that transplant.  By allocating the best 20% of kidneys to those candidates who can realize their full life-giving potential, we achieve two important goals.  First, we increase the total number of overall life years lived from the same pool of donor kidneys.  But more importantly, we can reduce the number of younger candidates who return to the wait list after their kidney transplant fails.  This, in turn, makes more kidneys available to others on the list, which is comprised of over 93,000 candidates awaiting a kidney transplant in the United States.

The proposal will be out for public comment for 90 days after which the UNOS Kidney Committee will consider any further modifications based on the public comment.  The proposal could go before the UNOS Board of Directors in June 2013 for final approval. 

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