There is a new system of allocation and matching for each deceased donor pancreas and kidney with each transplant candidate

By Mike Sosna
Published on January 3, 2020

The plan that I discussed with the LI TRIO board of directors has been approved. There is a new system of allocation and matching of each deceased donor pancreas and kidney with each transplant candidate.

The new allocation policy actually creates new distribution areas that are dependent on the donor location and the idea is to improve fairness and equity for candidates for a kidney and/or pancreas regardless of where they reside or where the transplant center (where the candidate is listed) is located.

We have stated that disparities based on geography are unfair. This new policy tries to limit how much geography is a factor in matching the deceased donor organs and the transplant candidates. This new policy will take effect later in 2020 and medical factors will be more highly weighted in matching and allocation decisions.

Here are the two tiers:

1. Kidney and pancreas offers will be officially offered to transplant candidates listed at a transplant center that is within 250 nautical miles of the donor hospital.

2. Offers that are not accepted for those candidates for transplant will be offered to candidates further away than the 250 nautical miles from the donor hospital.

Currently there is a three tiered system where almost all offers of a kidney or pancreas are allocated to hospitals within the same donation service area (DSA), This was based on the 58 arbitrary regions set up decades ago for Organ Procurement Organizations. Currently, offers that are not accepted in the DSA are offered to centers in other regions of the United States.

Here is a quote by Maryl Johnson, M.D. board president of The Organ Procurement and Transplantation Network:
“Under the current system, candidates listed at two different hospitals just a short distance apart from each other, and a short distance from a donor hospital, can appear much higher or lower on a match just because their hospitals are in different DSAs or regions,” Johnson said. “The new policy will remove those artificial distinctions for candidates who are much the same as each other in terms of distance and medical need.” In addition, statistical modeling indicates the policy will increase transplant access for key groups of transplant candidates, including children, women, ethnic minorities and those who are hard to match with many donor offers due to high immune sensitivity.”

We look forward to the implementation of this new allocation protocol.