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.
Related: Racial disparities in kidney transplantation rates eased by new allocation system
Preliminary study suggests new rules also increased transplantation rates for adults under 50 but significantly lowers them in those over 50. More
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.
Related: The top 5 most active transplant centers in 2014: a look at the waitlists
The median wait time for an individual’s first kidney transplant is 3.6 years. More
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.