The Kidney Allocation System

John J. Friedewald, Ciara J. Samana, Bert L Kasiske, Ajay K. Israni, Darren Stewart, Wida Cherikh, Richard N. Formica

Research output: Contribution to journalReview articlepeer-review

128 Scopus citations


The current kidney allocation system for transplants is outdated and has not evolved to reflect the changing demographics of patients on the waiting list. This article proposes a new system for kidney allocation, which more appropriately incorporates the biology of highly sensitized patients into the waiting-time scoring algorithm. This system will significantly reduce mismatches between possible donor kidney longevity and life expectancy of recipients, and makes incremental advances toward more geographic sharing. The proposed system makes significant progress toward eliminating deficiencies in the current system, and has the potential to increase the supply of available kidneys.

Original languageEnglish (US)
Pages (from-to)1395-1406
Number of pages12
JournalSurgical Clinics of North America
Issue number6
StatePublished - Dec 2013

Bibliographical note

Funding Information:
This work was conducted under the auspices of the Minneapolis Medical Research Foundation, contractor for the Scientific Registry of Transplant Recipients, as a deliverable under contract no. HHSH250201000018C (US Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation). As a US Government-sponsored work, there are no restrictions on its use. The views expressed herein are those of the authors and not necessarily those of the US Government. This work was supported wholly or in part by Health Resources and Services Administration contract 234-2005-370011C . The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government.

Copyright 2014 Elsevier B.V., All rights reserved.


  • Kidney transplant
  • Organ allocation
  • Transplant waiting list


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