Medical Reading

United Network For Organ Sharing Considers New Distribution System For Donor Kidneys

September 16, 2017

The United Network for Organ Sharing has begun to consider a proposal that would "favor young patients over old" in the distribution of donor kidneys to help "wring more life out of donated organs," the Wall Street Journal reports. In most cases, UNOS currently first distributes donor kidneys to patients in different regions who have waited the longest. Under the proposal, which remains in development, UNOS would first distribute donor kidneys based in large part on "net benefit," or which patients would benefit most. Research indicates that age is the most important factor in the length of time patients will live after a kidney transplant, and donated kidneys could provide significantly more years of life under a different distribution system. The new policy would increase the percentage of kidneys distributed to patients in their 20s from 6% to 19% and would decrease the percentage distributed to patients ages 60 and older from 24% to 12%, according to an estimate from the Scientific Registry of Transplant Recipients. Mark Stegall, chair of the UNOS kidney committee, said the committee has worked to draft a proposal that would provide the most years of life from donated kidneys and maintain "as much hope and equity in the system" as possible. The proposal likely will account for length of time on dialysis. Gabriel Danovitch, medical director at the University of California-Los Angeles, said, "We understand that some people will gain and some people will lose, but in the end, the purpose is to make the system a more sensible one." The proposal would require approval by the UNOS board and HHS.

Opponents of the proposal maintain that the current distribution system for donor kidneys "ensures that those waiting, if they hold out and stay alive, will eventually make it to the top of the list," the Journal reports. Richard Freeman, a transplant surgeon at Tufts-New England Medical Center, said, "Is it correct or permissible for the system to say the five or six more years of life that a 60-year-old is going to get are less valuable, less important than the 15 more years of life the 30-year-old is going to get?" Glenda Rosenbloom on behalf of the Transplant Recipients International Organization said, "We need a system which offers hope to all, regardless of age" (Meckler, Wall Street Journal, 3/10).

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