Moving kidney allocation forward: The ASTS perspective

R. B. Freeman, A. T. Matas, M. Henry, Dorry Segev, D. B. Kaufman, J. P. Roberts

Research output: Contribution to journalArticle

Abstract

In 2008, the United Network for Organ Sharing issued a request for information regarding a proposed revision to kidney allocation policy. This plan described combining dialysis time, donor characteristics and the estimated life years from transplant (LYFT) each candidate would gain in an allocation score that would rank waiting candidates. Though there were some advantages of this plan, the inclusion of LYFT raised many questions. Foremost, there was no clear agreement that LYFT should be the main criterion by which patients should be ranked. Moreover, to rank waiting candidates with this metric, long-term survival models were required in which there was no incorporation of patient preference or discounting for long survival times and for which the predictive accuracy did not achieve accepted standards. The American Society of Transplant Surgeons was pleased to participate in the evaluation of the proposal. Ultimately, the membership did not favor this proposal, because we felt that it was too complicated and that the projected slight increase in overall utility was not justified by the compromise in individual justice that was required. We offer alternative policy options to address some of the unmet needs and issues that were brought to light during this interesting process.

Original languageEnglish (US)
Pages (from-to)1501-1506
Number of pages6
JournalAmerican Journal of Transplantation
Volume9
Issue number7
DOIs
StatePublished - Jul 2009

Fingerprint

Transplants
Kidney
Survival
Patient Preference
Social Justice
Dialysis
Tissue Donors

Keywords

  • Allocation policy
  • LYFT
  • Patient prefence

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)

Cite this

Freeman, R. B., Matas, A. T., Henry, M., Segev, D., Kaufman, D. B., & Roberts, J. P. (2009). Moving kidney allocation forward: The ASTS perspective. American Journal of Transplantation, 9(7), 1501-1506. https://doi.org/10.1111/j.1600-6143.2009.02697.x

Moving kidney allocation forward : The ASTS perspective. / Freeman, R. B.; Matas, A. T.; Henry, M.; Segev, Dorry; Kaufman, D. B.; Roberts, J. P.

In: American Journal of Transplantation, Vol. 9, No. 7, 07.2009, p. 1501-1506.

Research output: Contribution to journalArticle

Freeman, RB, Matas, AT, Henry, M, Segev, D, Kaufman, DB & Roberts, JP 2009, 'Moving kidney allocation forward: The ASTS perspective', American Journal of Transplantation, vol. 9, no. 7, pp. 1501-1506. https://doi.org/10.1111/j.1600-6143.2009.02697.x
Freeman, R. B. ; Matas, A. T. ; Henry, M. ; Segev, Dorry ; Kaufman, D. B. ; Roberts, J. P. / Moving kidney allocation forward : The ASTS perspective. In: American Journal of Transplantation. 2009 ; Vol. 9, No. 7. pp. 1501-1506.
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