A new KAS was implemented in France as of February 2015, resulting from an intensive 3 yrs-simulation work in interaction with KTx advisory committee and patients' associations.

The new KAS was designed to improve transplant access rates and to maximize donor-recipient age and HLA matching for young adults, as to prevent on the long run the emergence of donor specific antibodies (DSAs).

In addition to existing national allocation priorities for urgent (no more possibility for dialysis), sensitized patients (full match, acceptable mismatch program) and children, a new scoring system was built, tacking into account dialysis duration, time on the waiting list, recipient age, donor-recipient HLA and age matching, recipient's matched donor potential (an indicator of low access to well matched donors, counterbalancing the weight given to HLA matching) and travel time between procurement and transplant centers.

At 21 months from its implementation, 5011 KTx were performed from DBD donors, allocated according to national priorities and programs (22%) and new allocation score at national level (32%) or local level (46%). Results compare the 21 months periods before and after new KAS implementation.

Significant changes were observed between the 2 periods in transplant access rates according to recipient's age (Figure 1) and in HLA-DR and DQ serological mismatches in young adults (Figure 2). Results conformed to targeted then simulated results.

Although progressive decline of transplant access rates with age may raise discussion according to the societal context of each country, age and HLADR/DQ matching increase in young adults is indeed an ubiquitous relevant target, as a tribute to the prevention of DSAs' emergence.

Figure 1Figure 2

CITATION INFORMATION: Jacquelinet C, Audry B, Bayer F, Macher M. The New Kidney Allocation System in France Meets it's Targets: Improving Age and HLA DR-QD Matching for Young Adults. Am J Transplant. 2017;17 (suppl 3).

« Back to 2017 American Transplant Congress