Nephrologynews.com-“Is the new kidney transplant allocation system fair?”
We have an epidemic in the United States—a shortage of kidneys. But older patients and those who have been on dialysis a long time waiting for a kidney are least likely to receive a deceased donor kidney transplant with the new kidney allocation system.
At 57 years old and over 13 years on dialysis when the new Kidney Allocation System was implemented last year, I immediately dropped significantly from the top percent of the list. Years on dialysis is no longer a factor in moving candidates up the list, in fact, it is the exact opposite. Years on dialysis now only is considered if there is a tie for a kidney. With KAS’s new goals of matching kidneys with similar age recipients and the effort to maximize the life of a kidney, it has reduced the chances of a deceased donor transplant for those over 50 and who have been on dialysis a long time waiting for a kidney.
The Kidney Allocation System new calculation, “Estimated Post Transplant Survival (EPTS)” score is assigned to all adult transplant candidates on the waiting list. If a candidate has a score of 20% or above then the transplant candidate will be eligible for available kidneys rated in the top 20% by KDPI (Kidney Donor Risk Index) calculation.
KAS’s new calculation method EPTS of prioritizing candidates for a kidney transplant is faulty in many ways.
In summary, the EPTS assumes a kidney will last longer with a candidate that is 35 years and younger compared to those 50 years and older, and it assumes that those who have been on dialysis a long time waiting for a kidney are least likely to keep a kidney for a long time. Also the EPTS calculation does not include proper criteria for determining a persons’ state of health.
Although this new system cannot be defined as “age-matching,” age is one major factor being used to determine transplant candidates’ placement on the waitlist. As a kidney dialysis patient waiting on the transplant list, it is hard to believe there is “age discrimination” in receiving a kidney transplant in the U.S.
Each day that I get older and each day that I am on dialysis, I get further away from receiving a deceased donor kidney.
Patients can go to OPTN website to see if they fall in the top 20% of donor recipients. If they do they will be eligible for available kidneys rated in the top rated 20%.
Check with your transplant surgeon on your status.
Note: “Preliminary study suggests new rules increase transplantation rates for adults under 50 but significantly lowers them in those over 50.”-nephrologynews.com
About the Author
Lana Schmidt, MBA
Ms. Schmidt is an NN&I Editorial Advisory Board member currently on home hemodialysis and waitlisted for a kidney transplant.
JANUARY 7, 2016
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