The kidney allocation system

Surg Clin North Am. 2013 Dec;93(6):1395-406. doi: 10.1016/j.suc.2013.08.007.


The current kidney allocation system for transplants is outdated and has not evolved to reflect the changing demographics of patients on the waiting list. This article proposes a new system for kidney allocation, which more appropriately incorporates the biology of highly sensitized patients into the waiting-time scoring algorithm. This system will significantly reduce mismatches between possible donor kidney longevity and life expectancy of recipients, and makes incremental advances toward more geographic sharing. The proposed system makes significant progress toward eliminating deficiencies in the current system, and has the potential to increase the supply of available kidneys.

Keywords: Kidney transplant; Organ allocation; Transplant waiting list.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Donor Selection*
  • Graft Survival
  • Humans
  • Kidney Transplantation* / mortality
  • Life Expectancy
  • Risk Assessment
  • Tissue and Organ Procurement / organization & administration*
  • Tissue and Organ Procurement / standards
  • Tissue and Organ Procurement / trends
  • Waiting Lists