A point score system for allocating cadaveric kidneys for transplantation based on patient age, waiting time and HLA match

AbstractA revised allocation system for cadaveric kidney donations was introduced in Hong Kong in July 1996 to take into consideration the age and waiting time of patients on the waiting list for transplantation, and the degree of HLA mismatch of the potential donor against the waiting patients. In recognition of the established benefits of transplanting donor kidneys with zero mismatched antigens against the recipient, the revised system provided that cadaveric kidneys would be transplanted whenever possible to patients against whom the donor had zero mismatched antigens. A total of 168 kidneys were allocated over a 45-month period using the revised system. The 3-year actuarial graft survival was 83%, which exceeded the figure reported for the same population 3 years previously. It is concluded that the revised system is fulfilling its desired objective to remove some older, long-term patients from the waiting list but that additional follow-up is required