• Daniel Zecher, Ineke Tieken, Josephine Wadewitz, Florian Zeman, Axel Rahmel, and Bernhard Banas.
• Department of Nephrology, University Hospital Regensburg, Regensburg, Germany; Eurotransplant Foundation, Leiden, Netherlands; German Organ Procurement Organization (DSO), Frankfurt am Main; Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany.
• Dtsch Arztebl Int. 2023 Jun 9; 120 (23): 393399393-399.

BackgroundIn order to achieve short ischemia times between organ donation and transplantation, regional organ allocation has been assigned priority in the development of allocation rules for kidney transplantation. It is unclear whether this leads to differences in regional waiting times in Germany.MethodsA retrospective cohort study over a 24-month observation period was conducted, including all patients who received a kidney-only graft allocated via the standard Eurotransplant Kidney Allocation System (ETKAS) (n = 1487) or the Eurotransplant Senior Program (ESP) (n = 566). Multiple linear regression analyses were performed to investigate differences in waiting times across the regions (ETKAS) or subregions (ESP) as defined by the German Organ Procurement Organization (DSO). Associations between the number of regionally procured kidneys (n = 1444) and regional waiting times were investigated.ResultsIn ETKAS, the median waiting time was 8.9 years (interquartile range [IQR] 6.7-10.6); in ESP, it was 3.9 (2.4 -5.3) years. Compared with the reference region with the shortest waiting time, waiting times in other regions were 0.6 to 1.7 years longer in ETKAS and 1.3 to 4.4 years longer in ESP. The ratio of the number of patients on the waiting list for a particular region to the number of organs donated in that region was associated with the waiting time in ETKAS (R2 = 0.70). In ESP, this association was markedly less pronounced (R2 = 0.45).ConclusionIn Germany, waiting times depend strongly on the region where a patient is listed for kidney transplantation, especially in ESP. These findings call the current allocation algorithms into question and imply a need for suitable modification.

14 keywords...

hide…