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The Kidney Transplant Wait-List: Allocation of Patients to a Limited Supply of Organs


Address correspondence to: Douglas J. Norman, MD, Department of Medicine, Oregon Health Science University, Transplantation/Immunogenetics, 2611 SW Third Ave., Suite 360, Portland, OR 97201, or e-mail:


The improvement of survival rates and the increasing demand for renal transplantation has resulted in tremendous growth of the deceased donor kidney waiting list. Unfortunately, over the same period, the number of deceased donor kidneys available for transplantation has only increased modestly. In this review, the rules by which deceased donor kidneys are allocated and distributed are reviewed. In addition, we discuss the ethical issues involved in the formulation of these policies and the implications for individual patients.