The Allocation of Cadaveric Kidneys

With the discovery of cyclosporine and anti–T-cell antibodies and the successful application of HLA matching, short-term and long-term graft-survival rates for cadaveric kidney transplants have improved dramatically. Nonetheless, there are more than 40,000 people in the United States waiting for a kidney transplant, with an ever-widening gap between supply and demand. The organ shortage has fueled the ongoing debate about how cadaveric kidneys should be allocated. This frequently rancorous debate has pitted patient against patient, physician against physician, smaller hospitals against larger institutions, and politicians from states with large multiorgan-transplantation programs against those from states with smaller programs.To address . . .