Age Should Be Considered in the Allocation of Deceased Donor Kidneys
Article first published online: 22 NOV 2012
© 2012 Wiley Periodicals, Inc.
Seminars in Dialysis
Volume 25, Issue 6, pages 682–685, November/December 2012
How to Cite
Shapiro, M. E. (2012), Age Should Be Considered in the Allocation of Deceased Donor Kidneys. Seminars in Dialysis, 25: 682–685. doi: 10.1111/sdi.12034
- Issue published online: 22 NOV 2012
- Article first published online: 22 NOV 2012
Organ allocation is a specific example of the allocation of scarce resources in a pluralistic society. As such, it is subject to both governmental and public scrutiny. It must follow the requirements of the federal legislation and regulations regarding “equitable allocation of organs.” An ideal allocation system should balance the ethical concepts of equity, or fairness, and utility, or usefulness. The current kidney allocation system has been in place, with some modifications over time, since the mid-1980s. It suffers from the changing demographics in ESRD, notably the aging of these groups, and in the growing length of the kidney waiting list. The current algorithm is thus imbalanced and requires reexamination. In particular, the system fails to match kidneys with long-projected function to recipients with long-projected lifespans, and vice versa. To improve the utility of kidney transplantation and lengthen the useful lifespan of these organs, a system that better matches kidneys and recipients is necessary, and this will require the use of recipient age in those calculations. The ethical questions and justification of such a system are presented.