This week I looked at kidney allocation in the UK.
Similar to the KAS and ETKAS, the UK also outlines its key objectives in creating its system. Most notably, it emphasizes having more effective quality matching, better HLA (human leukocyte antigen) matching by age, geographical equity, and avoiding prolonging the waiting times that are already predictable. As opposed to the US, they are fighting the geographical component. Since kidneys can only be transported under specific conditions and for a certain amount of time, it makes sense why geography is a factor. However, the US bases the allocation on availability nearby while the UK is trying to focus more on matches and is willing to spend resources on transporting the matched kidney to the patient in spite of distance.
The UK Kidney Offering Scheme was launched in 2019 to address concerns from the 2006 model. The new scheme allocated kidneys from both deceased and living donors more effectively by matching graft life expectancy with patient life expectancy. Graft survival is defined as time from transplant to graft failure. This is different from patient survival, which is defined as time from transplant to patient death. In other words, the UK system now tries to match the predicted time that the kidney will function with the predicted life expectancy of the patient so that patients are receiving kidneys that will last for their lifetime. This works well because now older patients with less life expectancy can still receive a kidney without taking one from a younger patient who has longer life expectancy.
Next week back to the data processing!