2016 s Commentary The Outstanding Kidney Exchange Papers.pdfVIP

PractitionersCommentary 167 Practitioners Commentary: The Outstanding Kidney Exchange Papers Somimer Gentry Dept. of Mathematics United States Naval Academy Annapolis, MhD 21402 gentryOusna. edu Mathematical Models Can Influence Public Policy on the Organ Shortage The topic of kidney allocation and the shortage of kidneys for transplan- tation was a timely choice for the Interdisciplinary Contest inModeling. In the past few years, public policy on organ donation and allocation has been changing rapidly, often in response to conclusions drawn from increasingly sophisticated mathematical models. Already in 2007, numerical projections of the significant impact of kidney paired donation in this country have prompted federal legislative and judicial action, which was necessary to clarify the inde- terminate legality of paired donation. Bills passed in the House and Senate, and a Department of Justice memorandum, state that paired donation does not violate the National Organ Transplantation Acts prohibition on giving organs for valuable consideration. The United Network for Organ Sharing (UNOS) is charged with oversight of all transplantation in the United States, including the allocation of organs from deceased donors to recipients. UNOS provides voluminous and easily accessible data on transplants at its Website http://www. uno6. org. Within the past five years, UNOS has completely redrawn allocation procedures for liver ard lung trahsplants. Recently, after statistical evidence showed that recipients with a liver allocation score of 15 or lower had shorter expected lifespans if they received a transplant than if they did not, liver allocation policy was revised to ensure that liver transplants went only to recipients who receive a survival benefit. The Department of Health and Human Ser