In Australia, the order in which kidneys from deceased donors are offered to people on the kidney transplant waiting list is determined by an algorithm.
 

This algorithm takes into account recipient characteristics (such as waiting time and sensitisation) as well characteristics of the donor-recipient match (the quality of the immunological match and the expected lifespan of the kidney compared to the recipient).
 

The current algorithm is reasonably effective at delivering fair allocation outcomes that respect waiting times, while also addressing the needs of specific high priority groups. However, the current algorithm also has limitations. 
 

The TSANZ Renal Transplant Advisory Committee established a Working Group in 2023 to address these limitations. Over an 18-month period, the Working Group consulted on design options for a new algorithm, tested these options and consulted with stakeholders.
 

The new design proposed by the Working Group is based on a continuous points score. Waitlisted individuals receive points for various attributes and these points are added together to give a final allocation score. This will change the way that patients are ranked in allocation by considering multiple patient factors simultaneously.
 

Compared to the current algorithm, modelling predicts that the new algorithm would achieve:

• Better matching of donors to recipients based on the expected lifespan of the kidney compared to the expected lifespan of the recipient

• Better immunological matching of donors to recipients

• More equal waiting times across different ethnic groups

• Slightly reduced waiting times for highly sensitised patients

• Lower waiting times for 18-34 year-olds, but slightly higher waiting times for 50-64 year olds

• Slightly reduced waiting times for the 65+ age group with closer prognosis matching.
   

We are now inviting feedback from the wider community on the new system. Click on "Full Details" to learn more about the new algorithm proposal. Technical details of the the new algorithm can be accessed by clicking on "Technical Specifications".