National Survey Carried Out by the Mexican Society of Transplantation in 2009 Regarding Deceased-Donor Kidney Allocation

Abstract Background The Mexican Health Law stipulated that the criteria to be taken into account for deceased donor kidney allocation should include the following: “seriousness of recipient's condition, opportunity of transplant, expected benefits, compatibility with recipient, and all other accepted medical criteria.” The practical application of these criteria has been perceived by several members of transplantation committees as allowing inequity in kidney allocation. The aims of this study were to learn the opinions of transplantation committees regarding current national allocation policies, and to obtain their opinions about the advantages of a point-score system. Methods A prepared questionnaire was validated with the collaboration of a team of transplantation physicians from the Mexican Society of Transplantation (MST). Ninety members of the Society, who represent transplantation groups were invited by mail to participate in the survey. Results We received 70 answered questionnaires, including 54 that represented the views of their respective internal transplantation committees. In agreement with the legislation and allocation policies currently in force were 50% of responders; however, 60% believed that a point-score system for organ allocation should be mandatory and 75% believed that only patients without a possible live donor should be included on the waiting list to compete for a deceased donor kidney. Also, 84% believed that only patients with a complete pre-transplant protocol, including recent viral serology, as well as clinically relevant pre-transplant evaluations by other specialists such as cardiology, psiquiatry/psychology and urology should qualify for allocation of deceased donor organs; 76% believed that patients who compete for a deceased donor organ must have permanent support for immunosuppressive drugs as well as for short-term and long-term medical care. Conclusion The answers gathered through this survey pointed out the necessity for continuous coordinated work between healthcare authorities and members of the MST to achieve the best guidelines for allocation of deceased donor kidneys including a point-score system.