Overview of the Evolution of the UK Kidney Allocation Schemes

摘要

Purpose of Review Allocation of deceased donor kidneys for transplantation has evolved since the first utilitarian approach in 1989. This review looks at how the schemes have evolved over the ensuing three decades. Recent Findings Four kidney offering schemes have been used in the last 30 years. Successive schemes have evolved from offering only one donor kidney for a nationally prioritised patient to offering both kidneys, from addressing only kidneys from donors after brain death (DBD) to offering kidneys from both DBD and circulatory death donors (DCD) and from prioritising purely on the basis of zero class 2 and minimising class 1 mismatches to a more relaxed approach for older donors and more difficult to match patients while introducing the concept of longevity matching. UK kidney offering schemes have evolved through a series of evidence-based analyses to try to optimally address the principles of utility and fairness in kidney offering.