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Author Topic: Perspective: Risk, Prognosis, and Unintended Consequences in Kidney Allocation  (Read 2374 times)

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Offline Clark

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http://www.nejm.org/doi/full/10.1056/NEJMp1102583?query=TOC

Perspective
Risk, Prognosis, and Unintended Consequences in Kidney Allocation
Benjamin E. Hippen, M.D., J. Richard Thistlethwaite, Jr., M.D., Ph.D., and Lainie Friedman Ross, M.D., Ph.D.
N Engl J Med 2011; 364:1285-1287April 7, 2011

  ....

Any proposal to revise the allocation of organs from deceased donors also risks causing unintended consequences for patterns and trends in donation by living donors. Past revisions to the allocation system warrant careful attention, since about 40% of donated kidneys come from living donors. Living kidney donations, which are not (and cannot be) accounted for in the proposal, confer a greater survival benefit than even optimal deceased-donor kidneys. A new rule (“Share 35”) was adopted in 2003 and implemented in 2005 to prioritize the allocation of organs from deceased donors younger than 35 to pediatric candidates, because of the adverse effect of end-stage renal disease on growth and cognitive development. The policy did result in more rapid transplantation of kidneys into children. However, the increased availability of deceased-donor kidneys was accompanied by a decrease in the number of living-donor kidneys donated to pediatric candidates (see http://www.nejm.org/action/showImage?doi=10.1056%2FNEJMp1102583&iid=f01) ...

Unrelated directed kidney donor in 2003, 500+ time blood & platelet donor and counting!
Rep to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, & Ad Hoc Public Solicitation of Organ Donors Committees 2005-2011

Offline Clark

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The presumption is that the sole motivation for all living donors is the perceived waiting time for their recipients.  It's more complicated than that and our diverse motivations, or, more importantly to this presumption, the diverse motivations of those who might donate but choose not to, have not been adequately studied.
Unrelated directed kidney donor in 2003, 500+ time blood & platelet donor and counting!
Rep to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, & Ad Hoc Public Solicitation of Organ Donors Committees 2005-2011

 

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