• Dtsch Arztebl Int · Aug 2024

    Observational Study

    Allocation Rules and Age-Dependent Waiting Times for Kidney Transplantation—an Analysis of Data From the German Transplantation Registry.

    • Benedikt Kolbrink, Nassim Kakavand, Jakob C Voran, Helena U Zacharias, Axel Rahmel, Serge Vogelaar, Silke Schicktanz, Felix Braun, Roland Schmitt, Friedrich A von Samson-Himmelstjerna, and Kevin Schulte.
    • Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany; Department of Internal Medicine III, Cardiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; German Center for Cardiovascular Research (DZHK), Partner site Hamburg/Kiel/Lübeck, Germany; Peter L. Reichertz Institute for Medical Informatics (PLTI), TU Braunschweig and Hannover Medical School, Hannover, Germany; German Organ Procurement Organization (DSO), Frankfurt am Main, Germany; Eurotransplant International Foundation, Leiden,Netherlands; Institute of Ethics and History of Medicine, University Medicine Göttingen, Göttingen, Germany; Division of Clinical Transplantation Medicine, Department of General, Visceral, Thoracic, Transplantation and Pediatric Surgery, University Hospital Schleswig Holstein Campus Kiel, Kiel, Germany.
    • Dtsch Arztebl Int. 2024 Aug 23; 121 (17): 559565559-565.

    BackgroundRigid age limits in the current allocation system for post-mortem donor kidneys in Germany may have problematic effects. The new German national transplantion registry enables data analysis with respect to this question.MethodsUsing anonymized data from the German national transplantion registry, we extracted and evaluated information on the recipients and postmortem donors of kidneys that were allocated in Germany through Eurotransplant over the period 2006-2020.ResultsData on 19 664 kidney transplantations in Germany from 2006 to 2020 were analyzed. The median waiting time for kidney transplantation was 5.8 years. Persons under age 18 waited a median of 1.7 years; persons aged 18 to 64, 7.0 years; and persons aged 65 and older, 3.8 years. Over the period of observation, postmortem kidneys were transplanted into 401 people of age 64 (2.0% of all organ recipients) and 1,393 people of age 65 (7.1% of all organ recipients). The difference in waiting times between allocation programs for persons under age 65 (ETKAS, "Eurotransplant Kidney Allocation System") and those aged 65 and older (ESP, "Eurotransplant Senior Program") increased over the period of observation, from 2.6 years in 2006-2010 to 4.1 years in 2017-2020.ConclusionThe rigid age limits in the current allocation rules for post-mortem kidney donations in Germany are prolonging the waiting times for transplants among patients aged 18 to 64. We think these rules need to be fundamentally reassessed.

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