Crafter Samuel R, Bell Lorraine, Foster Bethany J
Department of Pediatrics, Division of Nephrology (E-222), Montreal Children's Hospital, McGill University School of Medicine, Montreal, Canada.
Transplantation. 2007 Jun 15;83(11):1411-5. doi: 10.1097/01.tp.0000266580.19614.f7.
Deceased donor kidney allocation policy must balance the desire for high-quality organs, good human leukocyte antigen (HLA) matching, and minimal waiting times. We describe a 10-fold reduction in waiting times and an improvement in nonimmunologic indices of organ quality for child recipients after a change in organ allocation policy in Quebec, Canada. The new policy gives first priority to children (<18 yr) irrespective of HLA matching or waiting time. HLA matching after the policy change was predictably much worse. This study highlights the trade-offs that must be considered both in setting allocation policy and in decisions for individual recipients. We also consider potential unintended negative effects of such a policy change.
