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Age Should Be Considered in the Allocation of Deceased Donor Kidneys
Author(s) -
Shapiro Michael E.
Publication year - 2012
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12034
Subject(s) - scrutiny , medicine , equity (law) , legislation , demographics , health care rationing , scarcity , inequality , kidney transplantation , resource allocation , actuarial science , intensive care medicine , transplantation , computer science , microeconomics , law , economics , demography , economic growth , surgery , political science , mathematical analysis , health care , computer network , mathematics , sociology
Organ allocation is a specific example of the allocation of scarce resources in a pluralistic society. As such, it is subject to both governmental and public scrutiny. It must follow the requirements of the federal legislation and regulations regarding “equitable allocation of organs.” An ideal allocation system should balance the ethical concepts of equity, or fairness, and utility, or usefulness. The current kidney allocation system has been in place, with some modifications over time, since the mid‐1980s. It suffers from the changing demographics in ESRD, notably the aging of these groups, and in the growing length of the kidney waiting list. The current algorithm is thus imbalanced and requires reexamination. In particular, the system fails to match kidneys with long‐projected function to recipients with long‐projected lifespans, and vice versa. To improve the utility of kidney transplantation and lengthen the useful lifespan of these organs, a system that better matches kidneys and recipients is necessary, and this will require the use of recipient age in those calculations. The ethical questions and justification of such a system are presented.