Skip to main content

ORIGINAL RESEARCH article

Front. Public Health
Sec. Public Health Policy
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1500781

Assessment of Access and Outcomes of Kidney Transplantation through the Reforms of the Swiss Organ Allocation System

Provisionally accepted
Massimiliano Bertacchi Massimiliano Bertacchi 1*Sylvie Ferrari-Lacraz Sylvie Ferrari-Lacraz 1Jakob Nilsson Jakob Nilsson 2Agim Thaqi Agim Thaqi 3Yvan Schmutz Yvan Schmutz 4Caroline Wehmeier Caroline Wehmeier 5Thomas Schachtner Thomas Schachtner 2Thomas Friedrich Mueller Thomas Friedrich Mueller 2Dela Golshayan Dela Golshayan 6Julien Vionnet Julien Vionnet 6Stefan Schaub Stefan Schaub 5Fadi Haidar Fadi Haidar 1Isabelle Binet Isabelle Binet 7Jutta Thierbach Jutta Thierbach 8Urs Wirthmueller Urs Wirthmueller 9Daniel Sidler Daniel Sidler 9Franz Immer Franz Immer 10Jean Villard Jean Villard 1
  • 1 University Hospitals of Geneva, Geneva, Switzerland
  • 2 University Hospital Zürich, Zurich, Switzerland
  • 3 Federal Office of Public Health, Bern, Switzerland
  • 4 Analytica SA, Lausanne, Switzerland
  • 5 University Hospital of Basel, Basel, Switzerland
  • 6 Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
  • 7 Cantonal Hospital St.Gallen, St. Gallen, Switzerland
  • 8 Blood Transfusion Service Eastern Switzerland, Swiss RedCross, St Gallen, Switzerland
  • 9 University Hospital of Bern, Bern, Switzerland
  • 10 The Swiss National Foundation for Organ Donation and Transplantation (Swisstransplant), Bern, Switzerland

The final, formatted version of the article will be published soon.

    The Swiss allocation system for kidney transplantation has evolved over time to balance medical urgency, immunological compatibility, and waiting time. Since the introduction of the transplantation law in 2007, which imposed organ allocation on a national level, the algorithm has been optimized. Initially based on waiting time, HLA compatibility, and crossmatch performed by cell complement-dependent cytotoxicity techniques, the system moved in 2012 to a score including HLA compatibility, waiting time, anti-HLA antibodies detected by the Luminex® technology, and a virtual crossmatch. In 2015, the score was optimized to balance the impact of preemptive listing and HLA matching of hyperimmunized recipients.We reviewed access to transplants and post-transplant outcomes along those changes, defining

    Keywords: Kidney Transplantation, Allocation system, transplant immunology, allocation fairness, hyperimmunized patients, waiting time

    Received: 23 Sep 2024; Accepted: 24 Dec 2024.

    Copyright: © 2024 Bertacchi, Ferrari-Lacraz, Nilsson, Thaqi, Schmutz, Wehmeier, Schachtner, Mueller, Golshayan, Vionnet, Schaub, Haidar, Binet, Thierbach, Wirthmueller, Sidler, Immer and Villard. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Massimiliano Bertacchi, University Hospitals of Geneva, Geneva, Switzerland

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.