Evaluation of the Portuguese kidney transplant allocation system: comparative results from a simulation

Lima, Bruno A.; Alves, Helena

Publication

Evaluation of the Portuguese kidney transplant allocation system: comparative results from a simulation

2018-06Journal article

dc.contributor.author	Lima, Bruno A.
dc.contributor.author	Alves, Helena
dc.date.accessioned	2018-09-06T14:54:15Z
dc.date.available	2018-09-06T14:54:15Z
dc.date.issued	2018-06
dc.description.abstract	The distribution of such a scarce resource as deceased donor kidneys should be made by observing a balance between fairness, efficiency and flexibility. Before implementing a new kidney allocation system, these principles should be evaluated and assured objectively. In this article we compare the renal transplant donor-recipient pair selection system implemented in Portugal in 2007 with the Eurotransplant (ET) and United Kingdom (UK) systems. We simulated data for 500 waitlist kidney transplant candidates and 70 deceased donors. Each of the 70 donors was allocated to the best pair of listed candidates, taking into account the criteria of the three allocation systems under analysis. Subsequently, we compare the selected candidate’s groups to kidney transplant. The Portuguese organ allocation model selects candidates with a greater number of incompatibilities with the donor compared to the other two models. Under the Portuguese system’s rules, candidates have a greater age difference with the respective donors (median = 12.5 years) than those selected by the ET system (10 years) or the UK system (8 years). The Portuguese model selected more hypersensitized candidates (15%), but this difference was not statistically significant when compared to the percentage of hypersensitized patients selected by the ET model (10.7%). The Portuguese model has less equity than the other two models under analysis, since the observed disadvantages regarding the number of incompatibilities and age differences with the respective donor are not compensated for by the selection of patients with longer time on dialysis.	pt_PT
dc.description.version	info:eu-repo/semantics/publishedVersion	pt_PT
dc.identifier.citation	Port J Nephrol Hypert. 2018;32(2):136-142.	pt_PT
dc.identifier.issn	ISSN 2183-1289
dc.identifier.issn	0872-0169
dc.identifier.uri	http://hdl.handle.net/10400.18/5605
dc.language.iso	eng	pt_PT
dc.peerreviewed	yes	pt_PT
dc.publisher	Sociedade Portuguesa de Nefrologia	pt_PT
dc.relation.publisherversion	http://www.bbg01.com/cdn/rsc/spnefro/advaccess/139/06Nefro322Original3.pdf	pt_PT
dc.rights.uri	http://creativecommons.org/licenses/by-nc/4.0/	pt_PT
dc.subject	Access to Transplantation	pt_PT
dc.subject	Deceased Donor	pt_PT
dc.subject	Kidney Transplant	pt_PT
dc.subject	Organ Allocation	pt_PT
dc.subject	Portugal	pt_PT
dc.title	Evaluation of the Portuguese kidney transplant allocation system: comparative results from a simulation	pt_PT
dc.type	journal article
dspace.entity.type	Publication
oaire.citation.endPage	142	pt_PT
oaire.citation.issue	2	pt_PT
oaire.citation.startPage	136	pt_PT
oaire.citation.title	Portuguese Journal of Nephrology and Hypertension	pt_PT
oaire.citation.volume	32	pt_PT
rcaap.rights	openAccess	pt_PT
rcaap.type	article	pt_PT