Abstract
Transplant candidates waiting for a kidney transplant from a deceased donor are registered on a national transplant waiting list, maintained by the United Network for Organ Sharing (UNOS). UNOS matches deceased donor kidneys to recipients, taking into account both efficiency (graft and patient survival) and equity (fair distribution). Organ allocation is a complex system, taking into account blood type, HLA matching, degree of sensitization, pediatric recipients, and time waiting on the list. Listing practices take into account median wait times and allocation variances within the region, as well as list size, while optimizing resource utilization. There is a great disparity in the number of candidates awaiting kidney transplants compared to the number transplanted each year. UNOS is involved in a comprehensive review of the kidney allocation process, working toward improving the current system. The new allocation system would strive to maintain access for all candidates, while trying to maximize outcomes from each kidney.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Abbreviations
- CDC:
-
Centers for Disease Control and Prevention
- CPRAs:
-
Calculated panel reactive antibodies
- DCD:
-
Donation after cardiac death
- DSA:
-
Donor service area
- ECD:
-
Expanded criteria donors
- eGFR:
-
Estimated glomerular filtration rate
- EPTS:
-
Estimated posttransplant survival
- HLA:
-
Human leukocyte antigen
- KDPI:
-
Kidney donor profile index
- MPSC:
-
Membership and Professional Standards Committee
- NOTA:
-
National Organ Transplant Act
- OPO:
-
Organ procurement organization
- OPTN:
-
Organ Procurement and Transplantation Network
- PRA:
-
Panel reactive antibodies
- PSR:
-
Program-specific reports
- SCD:
-
Standard criteria donor
- SRTR:
-
Scientific Registry of Transplant Recipients
- UNOS:
-
United Network for Organ Sharing
- WIP:
-
Work-in-progress
References
U S Renal Data System, USRDS 2011 annual data report: atlas of chronic kidney disease and end-stage renal disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 2011
Leichtman AB, Cohen D, Keith D, O'Connor K, Goldstein M, McBride V, et al. Kidney and pancreas transplantation in the United States, 1997-2006: the HRSA breakthrough collaboratives and the 58 DSA Challenge. Am J Transplant. 2008;8(4 Pt 2):946–57. PubMed PMID: 18336698.
National Organ Transplant Act (NOTA). 1984.
Danovitch GM, Cohen DJ, Weir MR, Stock PG, Bennett WM, Christensen LL, et al. Current status of kidney and pancreas transplantation in the United States, 1994-2003. Am J Transplant. 2005;5(4 Pt 2):904–15. PubMed PMID: 15760417.
Port FK, Bragg-Gresham JL, Metzger RA, Dykstra DM, Gillespie BW, Young EW, et al. Donor characteristics associated with reduced graft survival: an approach to expanding the pool of kidney donors. Transplantation. 2002;74(9):1281–6. PubMed PMID: 12451266.
Ojo AO, Hanson JA, Meier-Kriesche H, Okechukwu CN, Wolfe RA, Leichtman AB, et al. Survival in recipients of marginal cadaveric donor kidneys compared with other recipients and wait-listed transplant candidates. J Am Soc Nephrol. 2001;12(3):589–97. PubMed PMID: 11181808.
Merion RM, Ashby VB, Wolfe RA, Distant DA, Hulbert-Shearon TE, Metzger RA, et al. Deceased-donor characteristics and the survival benefit of kidney transplantation. JAMA. 2005;294(21):2726–33. PubMed PMID: 16333008.
Schold JD, Meier-Kriesche HU. Which renal transplant candidates should accept marginal kidneys in exchange for a shorter waiting time on dialysis? Clin J Am Soc Nephrol. 2006;1(3):532–8. PubMed PMID: 17699256.
Grams ME, Womer KL, Ugarte RM, Desai NM, Montgomery RA, Segev DL. Listing for expanded criteria donor kidneys in older adults and those with predicted benefit. Am J Transplant. 2010;10(4):802–9. PubMed PMID: 20148808. Pubmed Central PMCID: PMC3146063.
Friedewald JJ, Reese PP. The kidney-first initiative: what is the current status of preemptive transplantation? Adv Chronic Kidney Dis. 2012;19(4):252–6. PubMed PMID: 22732045. Pubmed Central PMCID: PMC3384698.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer Science+Business Media New York
About this chapter
Cite this chapter
Friedewald, J.J., Chhabra, D., Ata, B. (2014). Wait List Management. In: Weir, M., Lerma, E. (eds) Kidney Transplantation. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0342-9_4
Download citation
DOI: https://doi.org/10.1007/978-1-4939-0342-9_4
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4939-0341-2
Online ISBN: 978-1-4939-0342-9
eBook Packages: MedicineMedicine (R0)