KAS clarifications

Proposal Overview

Status: Implemented

Sponsoring Committee: Kidney Transplantation

Strategic Goal: Provide equity in access to transplants

Policy notice (6/2016) - two parts

Effective 6/29/2017 - Policies 8.5.H and 8.7.A
Effective 9/1/2016 - See policy changes section for details

The OPTN implemented the revised kidney allocation system (KAS) on December 4, 2014. Since the OPTN/UNOS Board of Directors approved the policy in June 2013, the Kidney Transplantation Committee (the Committee) and UNOS staff have identified areas in which changes and clarifications are needed in the policy language. This proposal focuses on five areas for changes to kidney allocation policy:

Removing policy on mandatory sharing
Clarifying informed consent requirements for multi-organ candidates for kidneys based on KDPI greater than 85%
Maintaining consistency throughout kidney allocation policy with regard to Policy 5.9: Released Organs
Correcting match classification language in Table 8-5: Allocation of Kidneys from Deceased Donors with KDPI Less Than or Equal to 20%
Clerical changes

The Committee believes that the changes outlined in this proposal will provide clarification on kidney allocation policy and increase equitable access to very highly sensitized candidates. Other clarifications will improve the overall efficiency of KAS.

Board briefing paper (6/2016)

Public comment proposal (1/2016)

Feedback requested

Readers may comment on the entire proposal, but the Committee would like specific feedback on Policy 5.3.C: Informed Consent for Kidneys Based on KDPI Greater than 85% and Policy 8.5.C: Informed Consent for Kidneys Based on KDPI Greater than 85%. These policies require that, prior to receiving offers for kidneys with a KDPI score greater than 85%, transplant programs obtain written, informed consent from each kidney candidate willing to receive offers for kidneys in this category. The Committee would like to know:

Should the requirement for written, informed consent apply to multi-organ candidates that are registered for a kidney and another organ?

If this requirement does apply to multi-organ candidates, should consent be obtained prior to receiving offers? Or, should consent be obtained prior to transplant?

Effective 6/29/2017

Policy 8: Allocation of Kidneys
- 8.5.H
- 8.7.A

Effective 9/1/2016

Policy 5: Organ Offers, Acceptance and Verification
- 5.3.C
Policy 8: Allocation of Kidneys
- 8.2.B
- 8.5.C
- 8.5.D
- 8.5.E
- 8.5.F
- 8.5.G
- 8.6
- 8.7.B
- 8.7.C
- 8.7.D