Introduction: Thailand kidney allocation criteria has been established and implemented since 2002. The kidney allocation score is based on HLA antigen mismatch, HLA antibody, waiting time and the age of recipients which is concordance with worldwide criteria. Recently, Thai transplantation society reported that in 2021 the number of patients with long waiting time over 5 years had increased compared to 2020.
Objective: The study aimed to review the factors affecting recipient wait time.
Materials and Methods: A total of 6311 patients registered for kidney transplant at Organ Donation Centre, Thai Red Cross Society (ODC-TRC) program from July 2018 to May 2023 were analyzed.
Results: Among 2646 transplanted patients only 124 (5%) were highly sensitized. No significant difference was observed when compared an average waiting time between highly sensitized (5.78 years) and negative PRA (5.23 years) transplanted patients, p > 0.05. However, minimum and maximum waiting times were longer in highly sensitized (95 days to 30.29 years) than negative PRA recipients (20 days to 25.0 years). In addition, the significant difference was observed in patients who regularly submitted the current serum compared to those who did not do so, p < 0.05. Finally, Extended Criteria Donors (ECD) is not acceptable by some transplant centers. The significant difference was observed when compared average waiting time of recipients in transplant center with unaccepted ECD which was longer (5.42 years) than accepted ECD center (4.92 years), p < 0.05.
Conclusion: This study showed the factors affecting patients waiting times which were associated with both recipients and transplant centers. For highly sensitized patients, Single Antigen Beads kit should be performed to identify and avoid unacceptable antigen. All patients should be well informed concerning the significance of availability of current serum for crossmatch. Finally, ODC-TRC should regularly review and update the kidney allocation criteria including monitoring and evaluation the performances of the whole processes for the best use of donated organs.