UNOS Kidney Allocation: The Evolving Landscape ASHI 2021 Symposium

The United Network for Organ Sharing (UNOS) implemented a point-based kidney allocation policy on March 15, 2021 that placed higher priority on candidates that lived within a 250-mile circle surrounding the donor hospital. Dr. Murphey’s laboratory monitored kidney transplant statistics after the policy was implemented and used the UNOS kidney simulation model (KPSAM) to assess its predictive value. The average number of transplants per week involving kidneys from deceased donors increased in seven out of the eleven regions surveyed after the policy was implemented, and the average number of kidney transplants among children increased. The transplantation rate among Hispanic kidney recipients increased more than that of any other group, and the transplantation rate for African Americans increased as well. The kidney discard rate did not increase, and the discard rate for kidneys that were more difficult to place actually decreased. The new policy appeared to expand access to kidney transplantation, and the observed data were highly concordant with KPSAM modeling predictions.