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September 20, 2012

NYT: Flawed distribution system wastes life-saving organs

Daily Briefing

Thousands of people who need kidney transplants are dying because of an "inefficient" system to match donated kidneys with potential recipients, which results in many potentially implantable organs being discarded, the New York Times reports.

The current kidney matching system—which "amounts largely to first come first served," according to the Times—was designed by the federal government's Organ Procurement and Transplantation Network and is managed by the not-for-profit United Network for Organ Sharing.

The system divides the country into 58 donation districts. When a donor kidney becomes available, it is first offered to a compatible candidate within the district who has waited the longest, with additional priority given to children, candidates with hard-to-match blood types and candidates who match the best with the donor. If no donor is found, the search expands, eventually going national.

The kidney matching system does not consider the projected life expectancy of candidates or the urgency of the transplant, as do the systems for allocating hearts, livers, and lungs.

According to the Times, many experts say that the system is made inefficient because of outdated software, burdensome government oversight, doctors relying on inconclusive tests, and federal age-discrimination laws.

As a result, the system may not save as many lives as possible, the Times reports.

For example, in 2011, 4,720 people died while waiting for a kidney, while more than 2,600 kidneys that were recovered from cadavers were discarded without being transplanted. According to the Times, most of those kidneys went to research laboratories or straight to an incinerator. However, experts say that as many as half of those kidneys could have been transplanted if the allocation system was improved (Sack, New York Times, 9/19).

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