What Has Changed with the Implementation of National Cadaveric Kidney Allocation Policy in Turkey?

Objective: Previously, transplant centers in Turkey were free in selecting a potential recipient from their own local waiting list of deceased donor renal transplantation, and commonly patients with lower risk were selected. In May 2008, the Turkish Health Ministry issued a national cadaveric kidney allocation policy based on a pointing system. This system increased the equity but might have decreased the utility by elevating the risk of complications with possibly worse graft and patient survivals. We aimed to determine the short and medium-term effects of the new system on graft and patient survival. Methods: Forty-seven cadaveric renal transplant recipients who were transplanted before this system and 80 cadaveric renal transplant recipients who were transplanted under the new system were included. Short and medium-term transplant-related parameters were compared between the groups. Results: Patients transplanted after 2008 were older, had longer cold ischemia time, higher rates of delayed graft function, and early acute rejection. However, medium-term glomerular filtration rate, graft, and patient survivals were not different between patients transplanted before and after 2008. Conclusion: The new system in Turkey increased the opportunity for transplantation of previously disadvantageous patients and did not have a significant negative effect on medium-term renal functions. [ABSTRACT FROM AUTHOR]