UNOS requests public comment on organ allocation policies.
Deadline for comment is December 15, 2008!

Organ allocation policies determine the order in which candidates are offered an organ, when an organ becomes available for transplantation.  For many years, kidney allocation policy has been primarily a first come first served system with kidneys offered first to those who have been on the waiting list for the longest period of time, subject to blood type groups and cross-matching parameters. The current allocation order is also bases on geography, age, and antigens testing. The methods of allocation of deceased donor kidneys are going to change. For the purpose of this discussion, LYFT is the predicted extra remaining years of life that a candidate could expect with a transplant compared to his or her life without the transplant.

The OPTN/UNOS Kidney Transplantation Committee is now considering the following concepts which could work together to determine a candidate Kidney Allocation Score (KAS) and through a Request for Information, the Committee encourages anyone interested in kidney allocation to respond to a series of questions on the concepts listed below:

•  Life Years from Transplant (LYFT): Determines the estimated survival that a recipient of a specific donor kidney may expect to receive versus remaining on dialysis. LYFT is primarily a measure of utility. You will note...
• that LYFT scores tend to be higher for younger candidates and lower for older candidates. LYFT scores are also lower for diabetics receiving a kidney-alone rather thana simultaneous kidney-pancreas transplant.
•  Dialysis Time (DT): Time spent on dialysis allows candidates to gain priority over theperiod they receive this treatment.
•  Donor Profile Index (DPI): Provides a continuous measure of organ quality based onclinical information. DPI increases individual autonomy by providing a better metric fordeciding which organs are appropriate for which candidates.
•  LYFT, DPI, and DT are incorporated so that kidneys are matched to candidates based onthe expected survival of both the kidney and the recipient.
•  Solutions to limitations inherent in kidney allocation policy
  

The OPTN/UNOS Kidney Transplantation Committee continues to review methods to improve national policy for allocation of deceased donor kidneys. As a part of this ongoing process, the Committee is soliciting public input on concepts that may be used together in developing a future policy proposal.
The deadline for responses is December 15, 2008. Responses will be incorporated into additional public discussion, including a public forum tentatively scheduled for January 26, 2009.
A summary of responses to the RFI will also be posted to the OPTN and UNOS Web sites.

TRIO’s call to action: To find out how to submit a response, go to http://unos.org/news/newsDetail.asp?id=1151 for more information. Another source of information is: http://www.unos.org/kars.asp

Currently, the concepts are under review by the U.S. Department of Health and Human Services (HHS) Office of Civil Rights (OCR). The OCR is assessing whether the concepts are consistent with applicable federal laws, including the Age Discrimination Act.
- Mike Sosna, Chair, TRIO Public Policy Committee (email: mike@sosproductions.com)

Make your comments on the story above?  click on: TRIO Bulletin Board  Log in and post your questions, ideas and topics. Communicate with other transplant recipients, donors and families.  Check out our new topics and add your own suggestions.  Help build this community with your own postings to help others.  Add your own questions and thoughts.