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Result of new organ rules

Kidney transplants matching better

WASHINGTON — A shake-up of the nation’s kidney transplant system means more organs are getting to patients once thought nearly impossible to match, according to early tracking results.

It’s been a year since the United Network for Organ Sharing changed rules for the transplant waiting list, aiming to decrease disparities and squeeze the most benefit from a scarce resource: kidneys from deceased donors. Now data from UNOS shows that the changes are helping certain patients, including giving those expected to live the longest a better shot at the fittest kidneys.

The hope is to “really level the playing field,” said Dr. Mark Aeder, a transplant surgeon at University Hospitals Case Medical Center in Cleveland who is chairman of the UNOS’ kidney committee.

More than 101,000 people are on the national waiting list, while only about 17,000 kidney transplants are performed each year. Roughly 11,000 of them are with kidneys donated from someone who just died; the rest occur when a patient is able to find a living donor.

The wait for a deceased-donor kidney varies widely around the country, and in 2014, more than 4,500 people died before their turn.

The new policy altered how deceased-donor kidneys are distributed, shifting priorities so that how long you’ve been on the waiting list isn’t the main factor. Among the changes:

Fewer transplants are occurring in which the kidney is predicted to outlive the recipient. Now, the kidneys expected to last the longest — as calculated by donor age and medical history — are offered first to the patients expected to survive the longest. That’s called longevity matching.

The less time spent on dialysis, the better patients fare after a transplant. The new policy gives people credit for that dialysis time, moving them up the waiting list, and boosted transplants among long-time dialysis users, UNOS found.

Then there are those hardest-to-match patients, about 8,000 of them now on the waiting list. The new policy gives them special priority for organs that can be shipped to a wider area of the country than other kidneys, broadening the search for a super-rare match.

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