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Thursday, January 19, 2012

Proposed system for transplant kidney allocation contains bias against most diabetics

Corpus Christi Caller | Dr Stephen Ponder

CORPUS CHRISTI — Dialysis and organ transplantation are the only available choices to manage kidney failure. Almost 400,000 Americans receive hemodialysis three to seven days a week, and more than 12,000 undergo kidney transplantation each year. Roughly one-third of transplanted kidneys originate from living related donors and the remainder from random living or deceased individuals.

Survival after the procedure depends on several factors, including age, pre-existing medical condition, the adherence of the patient to daily anti-rejection medication schedules and regular follow-up visits.

About 25 percent of kidney transplants are a consequence of poorly controlled diabetes. While sustained, good diabetes control reduces the risk of kidney failure, it is no guarantee it can't still happen. Frankly, there are unique patient factors that contribute to this risk, which are not controlled by the patient or doctor.

The need for donated kidneys far exceeds the available supply. More than 110,000 people are on the waiting list. This gap will widen as the number of diabetics increases. Each year, more than 5,000 people die while on the kidney transplant waiting list.

The formula for allocating non-related kidneys for transplant considers length of time on the waiting list, geography and tissue compatibility. It's felt that there needs to be a new system to match organs with recipients that takes into account the health and age of the kidney and similar traits of the recipient. The goal is to maximize the life span of the patient and the transplanted organ.

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