Kidney Transplant Committee Proposes Changes Aimed at Better Use of Donated Organs

New York Times | Kevin Sack
After nine years of fitful work, the governance committee that oversees kidney transplants in the United States proposed a series of tweaks on Friday aimed at making better use of the country’s desperately inadequate supply of deceased-donor organs.

Central to the plan is a new index for better estimating the quality of the more than 14,000 kidneys recovered from dead donors each year. The top 20 percent of kidneys, as measured by the index, would be directed to those candidates expected to live the longest after a transplant — typically younger patients.

For that fortunate one-fifth, it would be a significant departure from the current wait-list system, which operates largely on a first-come-first-served basis. But for the other 80 percent, there would be little change in a process that has been criticized for the number of patients who die while waiting for a match, deep geographic disparities in waiting times and inefficiencies that lead to hundreds of viable organs being discarded each year.

Using computer simulations, the plan’s architects estimated the changes would produce an additional 8,380 years of life from one year of transplants. That is about half the number of years generated by a plan previously considered by the committee, which would have matched many kidneys to recipients by age. That plan was abandoned after federal officials warned last year that it would violate age discrimination laws.

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