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Editorial: Kidney transplant changes make sense

Updated: September 24, 2012 6:25AM

‘Rationing” is a dirty word these days, thanks to the ongoing fight over health-care reform.

There are times, though, when a scarcity of resources requires tough choices about how they will be distributed.

Such is the case with deceased-donor kidneys, the most sought-after organs for people on the national transplant waiting list. Of the more than 110,000 Americans on the list, nearly 88,000 need kidneys. But fewer than 17,000 people received kidney transplants in 2009, while more than 4,600 people died while waiting.

The United Network for Organ Sharing, in an attempt to make the most of scarce kidneys, has proposed modifying its “first come, first served” system for deceased-donor kidneys to one based more on age and post-transplant survival.

Specifically, the 20 percent of kidneys with the longest predicted functioning would be offered first to waiting-list candidates with the longest life expectancy. For the remaining 80 percent of kidneys, priority would be given to recipients who are no more than 15 years younger or older than the donor.

The current system, while seemingly more fair, sometimes results in young people receiving kidneys from much older people and elderly recipients getting young kidneys that have life expectancies much longer than their own.

Under the proposed changes, it’s inevitable that fewer people over 50 would receive kidney transplants, while more young people would get them.

Yet most candidates, because they are already within the 15-year age range being proposed, would see little difference in the kidneys they are offered.

Our one concern is that making the allocation formula more nuanced than it is now could hurt public confidence in the fairness of the process.

The real answer is more people saying yes to organ donation. But until there are enough organs to go around, let’s get the most from every transplant.

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