Organ allocation systems and management of the renal transplant waiting list.

In 1996 the EUROTRANSPLANT organisation, which currently includes the member-states Austria, Belgium, Germany, Luxemburg, the Netherlands and Slovenia, changed its policy of renal donor organ allocation to the new algorithm ETKAS (Eurotransplant Kidney Allocation System). Its main goal was to shorten the average and maximum waiting time, adjust for rare HLA phenotypes and homozygosities, achieve a reasonably balanced exchange rate among countries with variable organ procurement rates and guarantee an acceptable HLA match distribution and a optimal overall transplant success rate. Several additions have been introduced since then such as the Eurotransplant Senior Programme, which allocates kidneys from donors older than 65 years to recipients over the age of 65. Due to constant refinement the system has achieved its major goals.