Procedures and criteria for accepting the renal patient for inclusion on the waiting list for kidney transplantation in the Nordic countries

Background: The overall aim of this study was to survey and analyze the selection process for patients awaiting a kidney in the Nordic countries collaborating within Scandiatransplant.

Methods: A two-parts questionnaire was sent to one senior physician at each of the 10 Scandiatransplant kidney transplantation centers that use deceased donors. The first part consisted of questions related to the evaluation of a patient for the waiting list. The second part of the questionnaire dealt with 12 borderline cases, based on experiences at seven of all centers. Answers should be given with the policy of the center in mind. The response rate was 100%.

Results: Some centers are stricter than others regarding limits for body mass index and cardiac ejection fraction. At three centers, human immunodeficiency virus-positive patients are not included on the list. Four centers have a policy of not including predialysis patients. All centers agreed that they would not refrain from acceptance of a patient due to the scarcity of organs, if the patient was considered to benefit medically from transplantation. Reevaluation of the patient once on the list is done at all centers, focusing on cardiovascular problems. Only a few respondents were positive to the idea of common Nordic guidelines for investigations or for limiting values.

Conclusions: We concluded that there are some, mainly small, differences among Nordic countries regarding procedures and criteria for acceptance of patients on the waiting list for kidney transplantation. The interest in common guidelines is limited.