The Organ Procurement and Transplantation Network and the United Network for Organ Sharing (OPTN/UNOS) board of directors approved in June substantial amendments to OPTN policy for deceased donor kidney allocation. The boards say the policy will maintain access to kidney transplantation for all groups of candidates while seeking to improve outcomes for kidney transplant recipients, increase the years recipients may have a functioning transplant, and increase utilization of available kidneys. The implementation date of the policy was not immediately established but is expected to occur in 2014.
“These changes will result in better long-term kidney survival and more balanced waiting times for transplant candidates,” said OPTN/UNOS President John Roberts, MD.
The newly approved policy includes new factors not used in the current policy. Existing definitions of “standard criteria” and “extended criteria” donors will be replaced with the Kidney Donor Profile Index (KDPI), a clinical formula that classifies donor kidneys based upon how long they are likely to function once transplanted. Kidney transplant professionals already have access to this index as an informational resource.
The policy will also include a clinical formula to estimate the number of years each specific candidate on the waiting list would be likely to benefit from a kidney transplant. The score is called the estimated post-transplant survival formula (EPTS). Under the new policy, when a kidney donor is entered into the matching system, that individual donor’s KDPI score will be considered along with the individual EPTS for compatible candidates. “A limited number of kidneys expected to function the very longest will be considered first for the candidates expected to need them for the longest amount of time,” said John Friedewald, MD, chairman of the OPTN/UNOS Kidney Transplantation Committee.
The policy is expected to increase overall “life-years” (time that recipients retain kidney function after the transplant). It may also reduce recipients’ future need for repeat transplants, thus allowing more transplants among candidates awaiting their first opportunity, the boards said.
Read more about the policy changes at NephrologyNews.com/Transplant.