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This month The AJT Report looks at the LYFT kidney‐allocation concept, and where it may have gone wrong, as well as research that shows how television news stories about transplants often leave out important information for donors.
The use of “Life Years from Transplant” (LYFT) to allocate kidneys is controversial. Several articles in this issue of AJT present critiques and analysis of KAS and LYFT and provide a road map for future progress. See Special Feature on pages 1500–1532.
The current issue contains a report contradicting an earlier report published in this journal casting doubt on the association of HLA‐C genotype with liver transplant outcomes. See Brief Communication by Tran et al on page 1674–1678.
In addition to assessing survival, comprehensive studies of donor allocation system outcomes should assess issues such as morbidity and quality of life. See Article by Titman et al on page 1640–1649.
The concentration–effect relationship for mycophenolic acid (MPA), and the high variability in MPA concentrations in patients on standard dose mycophenolate mofetil (MMF) therapy, for some centers has provided enough evidence to implement therapeutic drug monitoring (TDM) for MMF in daily...
In the present format the proposed new allocation system does not achieve an acceptable balance between justice and equity.
In 2008, the United Network for Organ Sharing issued a request for information regarding a proposed revision to kidney allocation policy. This plan described combining dialysis time, donor characteristics and the estimated life years from transplant (LYFT) each candidate would gain in an...
The growing disparity between the demand for and supply of kidneys for transplantation has generated interest in alternative systems of allocating kidneys from deceased donors. This personal viewpoint focuses attention on the Kidney Allocation Score (KAS) proposal promulgated by the UNOS/OPTN...
Over the last 5 years, a number of utility‐based allocation systems have been proposed in an effort to increase the life‐prolonging potential of deceased donor kidneys in the United States. These have included various adaptations of age‐matching and net benefit, including the Eurotransplant...
A potential strategy for a new allocation system for kidney allocation should match predicted longevity of the donor kidney with predicted survival of the transplant recipient, while balancing the disparate goals of the multiple stakeholders.
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