Demand, supply and allocation in Eurotransplant

Area of Science:

• Nephrology
• Transplant Surgery
• Public Health Policy

Background:

• Organ transplantation faces a critical shortage of available organs, with demand consistently exceeding supply.
• In 1996, Eurotransplant counties saw no significant increase in organ availability, while waiting lists continued to grow.
• Scarcity impacts organ distribution, necessitating optimized allocation strategies.

Purpose of the Study:

• To address the growing demand in renal transplantation programs.
• To design and implement a novel kidney allocation system.
• To evaluate the system's impact on organ procurement, transplantation rates, and donor-recipient matching.

Main Methods:

• Development of a specialized kidney allocation system informed by extensive simulation studies.
• Implementation of the new system across participating Eurotransplant countries.
• Monitoring of key performance indicators including organ procurement, transplantation frequencies, waiting list dynamics, and human leukocyte antigen (HLA) matching.

Main Results:

• Discrepancies in kidney procurement and transplantation rates among Eurotransplant countries were eliminated shortly after system implementation.
• The number of kidney transplants for patients on long waiting lists doubled compared to previous rates.
• A high percentage, nearly 24%, of human leukocyte antigen (HLA) donor-recipient combinations remained well-matched.

Conclusions:

• The new kidney allocation system effectively mitigated disparities in organ transplantation across Eurotransplant counties.
• The system significantly improved access to transplantation for patients with long waiting times.
• The allocation strategy successfully maintained a high rate of successful human leukocyte antigen (HLA) donor-recipient matching, optimizing transplant outcomes.