is difficult to predict when a kidney from a deceased donor will become
available for you. The wait list is divided by the blood group: A, B, O, and AB. Every person will be in his or her individual blood group while waiting for the deceased donor organ. Blood types must be compatible. Certain blood types such
as B or O will usually have longer waiting time than others because of the scarcity of donors. Also, patients with many antibodies to different HLA
antigens (structures on the transplanted kidney that your immune system
recognized as “foreign”) will wait longer. Finally, some geographic regions
have fewer organ donors than others, so patients in these regions wait longer
for all types of transplants. For most people, the length of time spent on the
waiting list determines when a kidney will become available for them.
new kidney allocation system went into effect on December 4, 2014; its intent
is to match kidney donors and recipients with the best survival potential, to
increase the chance of transplanting people with many antibodies to HLA antigens, and attempt to decrease the number of discarded kidneys. Priority points are given for various things, and the candidate with the most points AND
a compatible cross-match will be offered the kidney.
of the important points of this system points are explained below:
scores that describe potential post-transplant survival were created and are
For Patients - the EPTS score = Expected Post Transplant
is based on four factors:
For Donors – the KDPI score = Kidney Donor Profile Index score
score is an estimate of how likely a kidney will fail. Multiple donor factors
are used to calculate the score including the potential donor’s:
of the factors used to determine the scores are known to affect survival (EPTS)
or kidney function after transplantation ((KDPI).The scores are shown as percentages(from 1 to 100%) with the lower
numbers indicating better survival
or function. Kidneys with a KDPI of 20% or less will be offered first to adult
candidates with EPTS of 20% or less and then to patients with higher EPTS scores
taking into consideration length of time on the waiting list and HLA antibody
will be asked to sign a separate consent if you are willing to accept a kidney
with a KDPI score of 85% of greater.
These kidneys have a lower expected survival rate than kidneys with low
scores, but more than half will still be functioning 5 years after
transplantation. Your transplant doctor
will discuss this with you in detail and answer all questions you may have.
candidates” refers to patients who have developed antibodies to one or more HLA
antigens. Antibody to the HLA antigen develops when a person is exposed to another person's blood or tissue through blood transfusion or previous organ transplantation. You cannot receive a kidney if you have an antibody to one of its HLA
antigens because the presence of your antibody against the HLA antigen will lead to the process of rejection. Rejection is a process whereby your body will attack the organ in an attempt to destroy it. The more antibodies that a person has against different HLA antigens, the more difficult it is to find a compatible kidney. The new
allocation system assigns priority points to patients with these antibodies,
with more points being given for larger number of antibodies. Patients who are highly sensitized
(those who react to 98% or more of likely HLA antigens) receive both regional
and national priority for available kidneys. The extra priority points are given in the following way: 24.4
(98%), 50.09 (99%), or 202.1 (100%) points to the waiting time of these highly sensitized patients.
In the past, the date a person was placed on the UNOS waiting list, he or she begins to accrue time from that moment onward. In the new system, patients receive waiting time credit for time spent on dialysis before being placed on the waiting list.
you're waiting for a kidney to become available, we will need monthly blood
samples sent to the laboratory to test for antibodies. This is to make sure that a current sample of your blood
will be available for cross-matching if a kidney should become available for
you. Your coordinator will work with you or your dialysis center to arrange
this monthly blood test.
has established guidelines you must follow in order to remain eligible for a
kidney transplant. It is your responsibility to abide by these guidelines:
is very important that you call us to inform us of any of the following situations:
Information about our living donor program.
Discover how our integrated, multidisciplinary group practice can provide you outstanding care.