This week I looked at how other countries allocate kidneys.
The Eurotransplant Kidney allocation system (ETKAS) is constantly evolving to improve its methods. It explicitly wants to achieve the following goals:
- Optimal Use Of Available Donor Organs
- Objective And Transparent
- Based In Scientific Research
- Assess Based On The Most Important Factors
- Increasing Amount Of Donations
It is common to see this amongst every nation. The difference comes into the implementation of how they are able to achieve these goals. ETKAS applies to Austria, Belgium, Germany, Luxemburg, the Netherlands and Slovenia, almost 118 million people. It is allocated through an algorithm.
This program uses urgency codes, including transplantability (are they able to receive transplant), medical urgency, and most recent level of allosensitization (presence of antibodies that decrease a given candidate’s possible donor pool). High urgency is based in objective standards as well. If they are unable to receive other care or have a pre-existing condition clearly diagnosed that could put them at greater risk, then that particular patient is recognized to have high urgency by the Eurotransplant. Additionally, the system goes into much greater detail regarding age and living vs deceased donors. With a few exceptions, patients over 65 years of age receive deceased donor kidneys in order to fulfill the longevity aspect of transplant outcome (since the patients are older).
ETKAS was implemented in 1996 and since then, there have been a lot of improvements. It shortened the average waiting time. 36 % of kidneys were transplanted into recipients with a wait time of over 5 years. Despite the number of countries involved, a fairly balanced kidney exchange rate has been maintained. Lastly, it turned out to be much more successful for children needing transplants.
Next week, I will be looking at one other country/area that assorts kidneys differently. Then, back to the STATs!