PMID- 20177339 OWN - NLM STAT- MEDLINE DCOM- 20100401 LR - 20220316 IS - 1534-6080 (Electronic) IS - 0041-1337 (Linking) VI - 89 IP - 4 DP - 2010 Feb 27 TI - A New UK 2006 National Kidney Allocation Scheme for deceased heart-beating donor kidneys. PG - 387-94 LID - 10.1097/TP.0b013e3181c9029d [doi] AB - In 2004, it was agreed that a new allocation scheme for kidneys from deceased heart-beating donors was required in the United Kingdom to address observed inequities in access to transplant. The 2006 National Kidney Allocation Scheme (2006 NKAS) was developed to meet agreed objectives and preparatory work included a review of the criteria for human leukocyte antigen (HLA) matching and simulation evidence about the effectiveness of alternative schemes. ALGORITHM FOR 2006 NKAS: The 2006 NKAS gives absolute priority to all 000 HLA-A, -B, -DR-mismatched patients and well-matched pediatric patients (<18 years), and then a points score defines priorities for allocation with waiting time being most influential. Points for age and HLA mismatch are linked in a novel approach to ensure well-matched transplants for younger patients while recognizing that HLA matching is less important for older patients as retransplantation is less likely to be required. To improve equity for difficult to match patients, rare HLA specificities were defaulted to more common, related specificities. IMPACT OF 2006 NKAS: After 3 years, the scheme is already making good progress in achieving its objectives, with overall results similar to those observed in the simulations. There has been a significant benefit for patients waiting more than 5 years for transplant. A number of other advantages of the scheme are also apparent with equity of access improving in many respects, including the achievement of equity of access to transplant for HLA-DR homozygous patients, but geographical inequity of access will take a number of years to address fully. FAU - Johnson, Rachel J AU - Johnson RJ AD - Organ Donation and Transplantation, NHS Blood and Transplant, Fox Den Road, Stoke Gifford, Bristol BS34 8RR, United Kingdom. rachel.johnson@nhsbt.nhs.uk FAU - Fuggle, Susan V AU - Fuggle SV FAU - Mumford, Lisa AU - Mumford L FAU - Bradley, J Andrew AU - Bradley JA FAU - Forsythe, John L R AU - Forsythe JL FAU - Rudge, Chris J AU - Rudge CJ CN - Kidney Advisory Group of NHS Blood and Transplant LA - eng PT - Journal Article PL - United States TA - Transplantation JT - Transplantation JID - 0132144 RN - 0 (HLA Antigens) SB - IM MH - Adult MH - *Cadaver MH - Child MH - Delivery of Health Care/standards MH - Graft Survival MH - HLA Antigens/immunology MH - Heart Rate MH - Histocompatibility Testing/methods MH - Humans MH - Kidney Transplantation/immunology/mortality/*statistics & numerical data MH - Patient Selection MH - Resource Allocation/*methods/standards MH - Survival Rate MH - Tissue Donors/*statistics & numerical data MH - Treatment Outcome MH - United Kingdom MH - Waiting Lists FIR - Fuggle, Susan IR - Fuggle S FIR - Ansell, David IR - Ansell D FIR - Maxwell, Heather IR - Maxwell H FIR - Cain, Paulette IR - Cain P FIR - McPake, Dawn IR - McPake D FIR - Diggle, Peter IR - Diggle P FIR - Oniscu, Gabriel IR - Oniscu G FIR - Dudley, Chris IR - Dudley C FIR - Powis, Steve IR - Powis S FIR - Dyer, Phil IR - Dyer P FIR - Ready, Andrew IR - Ready A FIR - Higgins, Rob IR - Higgins R FIR - Rigg, Keith IR - Rigg K FIR - Johnson, Rachel IR - Johnson R FIR - Warrens, Anthony IR - Warrens A FIR - Lewis, Helen IR - Lewis H FIR - Watson, Chris IR - Watson C FIR - Mason, Phil IR - Mason P FIR - O'Neill, John IR - O'Neill J FIR - Start, Samantha IR - Start S FIR - Fuggle, Sue IR - Fuggle S FIR - Barnardo, Martin IR - Barnardo M FIR - Shelper, Linda IR - Shelper L FIR - Briggs, David IR - Briggs D FIR - Taylor, Craig IR - Taylor C FIR - Dyer, Phil IR - Dyer P FIR - Vaughan, Robert IR - Vaughan R FIR - Martin, Susan IR - Martin S FIR - Watson, Chris IR - Watson C EDAT- 2010/02/24 06:00 MHDA- 2010/04/02 06:00 CRDT- 2010/02/24 06:00 PHST- 2010/02/24 06:00 [entrez] PHST- 2010/02/24 06:00 [pubmed] PHST- 2010/04/02 06:00 [medline] AID - 00007890-201002270-00004 [pii] AID - 10.1097/TP.0b013e3181c9029d [doi] PST - ppublish SO - Transplantation. 2010 Feb 27;89(4):387-94. doi: 10.1097/TP.0b013e3181c9029d.