Original InvestigationTransplantationAllocation of Deceased Donor Kidneys for Transplantation: Opinions of Patients With CKD
Section snippets
Methods
A questionnaire was constructed with 9 scenarios. In each scenario, the participant was invited to select which 1 of 2 hypothetical patients should receive a deceased donor kidney. Each scenario explored a different aspect of current allocation schemes. Two of the scenarios presented were very similar and were included to test patient understanding of the issues (internal validation). The questionnaire included a 1-page information sheet about deceased donor kidney allocation and was anonymous
Results
Two hundred thirty-two of 295 invited patients (78.6%) completed the questionnaire, consisting of 104 of 153 invited hemodialysis patients (68.0%) and 128 of 142 invited transplant recipients (90.1%). Age and sex distribution and transplant history are listed in Table 2. Average age, sex distribution, and percentage of patients on the transplant waiting list were similar in patients who did not participate (data not shown).
Discussion
The subject of organ allocation has stimulated debate since the early days of renal transplantation. A balance must be struck between optimizing overall graft outcomes (often termed “utility”) and providing patients with a reasonable opportunity for transplantation (often termed “justice”). This debate has been heightened recently with increasing evidence of a significant survival advantage for those who undergo transplantation over wait-listed patients who remain on dialysis therapy.1 It is
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Cited by (25)
Public Perception of Organ Donation and Transplantation Policies in Southern Spain
2022, Transplantation ProceedingsCitation Excerpt :Another systematic review also encountered a preference for utilitarian criteria among health care professionals, which is not the case among patients, who mostly lean toward urgency [29]. Our study shows that a majority of the public prefers allocating organs based on nonutilitarian criteria, which is consistent with other surveys on allocation conducted over the last 2 decades within diverse segments of the population and in different countries [30,31]. Further research is needed to better understand lay people's preferred moral pathways in organ allocation.
Comparing preferences of physicians and patients regarding the allocation of donor organs: A systematic review
2020, Transplantation ReviewsCitation Excerpt :This general tendency is confirmed by the qualitative studies as well [21,27,30]. The time a candidate for transplantation has been on the waiting list has been evaluated in six different studies [21,24–27,30], whereas especially the quantitative studies show a preference for candidates longer on the waiting list in both physicians and patients [24,26]. The impact of whether the recipient is compliant with pre- and post-transplantation treatment on the allocation decision has been evaluated in six different studies [20–24,30].
A new kidney allocation policy in Chile: Computer-based simulations
2013, Transplantation ProceedingsCitation Excerpt :Additionally pediatric recipients (younger than 18 years) receive extra points. After gathering information on other allocation systems by a literature review,3–10 a new system was initially proposed and a consensus reached among transplantation physicians. The new system is also based on ABO identity, but incorporates several tiers at which kidney offers are made to patients: first, medical priorities, and consecutively to living individuals who had previously acted as kidney donors; 0–HLA mismatched (mm) recipients; and pediatric cases.
Organ allocation system in chile: proposals for a modification of the distribution of cadaveric kidneys for transplantation
2010, Revista Medica Clinica Las CondesPotential Inefficiency of a Proposed Efficiency Model for Kidney Allocation
2008, American Journal of Kidney DiseasesA Recipient Risk Score for Deceased Donor Renal Allocation
2007, American Journal of Kidney Diseases
Originally published online as doi:10.1053/j.ajkd.2005.07.031 on October 3, 2005.
C.C.G. conceived the study, designed the questionnaire, designed the study, analyzed the data, and drafted the manuscript; R.S.C.R. had a major role in designing the questionnaire and drafting the manuscript; C.S. had a major role in designing the questionnaire and collecting and analyzing the data; and A.G. had a major role in collecting the data.