Advertisement

Increasing kidney supply as the best solution to the allocation problem

  • P. I. Terasaki
  • J. M. Cecka
  • D. W. Gjertson
  • Y. Cho
  • S. Takemoto
Part of the Transplantation and Clinical Immunology book series (TRAC, volume 30)

Abstract

Numerous allocation schemes have been proposed. The most important feature they have in common is providing a rationale of why one patient receives the kidney, and 35 000 others do not. In the United States in 1998 some 20 000 patients may wait in vain for, despite having a chance to obtain a kidney, they could not … simply because there were not enough kidneys to satisfy the demand. As the disparity between the number of waiting patients and the number who actually receive a kidney widens, allocation formulas become more and more overbearing. Ideally, allocation should be based on what combination would result in the best long-term medical outcome for the patient. As long as the kidney shortage problem continues to worsen, allocation tends to become more and more influenced by extraneous factors, such as donating center points, distance to patient, waiting time, etc.

Keywords

Living Donor Donor Kidney Cadaver Donor Living Kidney Donor Transplantation Allocation Formula 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Terasaki PI, Gjertson DW, Cecka JM, Takemoto S, Cho YW. Significance of donor age effect on kidney transplants. Clin. Transplant. 1997; 11: 366–372.PubMedGoogle Scholar
  2. 2.
    Terasaki PI, Cecka JM, Gjertson DW, Takemoto S. High survival rates of kidney transplants from spousal and living unrelated donors. N. Engl. J. Med. 1995; 333: 333.PubMedCrossRefGoogle Scholar
  3. 3.
    Terasaki PI, Gjertson DW, Cecka JM. Letter to editors, Transplantation. 1998 (In press).Google Scholar
  4. 4.
    Ross LF, Rubin DT, Siegler M et al. Ethics of a paired-kidney-exchange program. N. Engl. J. Med. 1997; 336: 1752.PubMedCrossRefGoogle Scholar
  5. 5.
    Tanabe K, Takahashi K, Sonoda T et al. ABO-incompatible living kidney donor transplantation: results and immunological aspects. Transplant. Proc. 1995; 27: 1020.PubMedGoogle Scholar
  6. 6.
    Johnson LB, Kuo PC, Dafoe DC et al. The use of bilateral adult renal allografts — a method to optimize function from donor kidneys with suboptimal nephron mass. Transplantation. 1996; 61: 1261.PubMedCrossRefGoogle Scholar
  7. 7.
    Kootstra G, The asystolic, or non-heartbeating, donor. Transplantation. 1997: 63; 917.PubMedCrossRefGoogle Scholar
  8. 8.
    Kowalski AE, Light JA, Ritchie WO et al. A new approach for increasing the organ supply. Clin. Transplant. 1996; 10: 653.PubMedGoogle Scholar
  9. 9.
    Cho YW, Terasaki PI, Gjertson DW, Cecka JM. A major new source of kidneys for transplantation: non-heart beating donors. N. Engl. J. Med. 1998; 338: 221–225.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1998

Authors and Affiliations

  • P. I. Terasaki
  • J. M. Cecka
  • D. W. Gjertson
  • Y. Cho
  • S. Takemoto

There are no affiliations available

Personalised recommendations