Use of Offer Bypass Filters under the Circular Kidney Allocation System

What is it about?

Under the new distance-based kidney allocation system (KAS250), transplant centers have reported increases in the volume of organ offers received and operational burden. Centers can set filters based on donor characteristics to have all their patients automatically bypassed for certain organ offers. Our study shows that almost all centers experienced an increase in organ offer volume under KAS250. Even centers with more restrictive filter settings saw increases in offer volume and a decrease in the proportion of offer refusals that occurred via bypass. Despite large increase in organ offer volume, most centers do not appear to be making their center-wide bypass filter settings more restrictive to preemptively screen out offers they already know they will not accept. This suggests a need to redesign the bypass filters to help centers overcome the fear of missing out and manage the increased logistical burden under KAS250 in order to ensure an efficient allocation system with fewer organ discards.

Featured Image