ABSTRACT
Patients with end-stage renal disease (ESRD; also known as kidney failure) must address the deficit in renal function through dialysis or kidney transplantation. Kidney transplantation has been repeatedly demonstrated to be superior to dialysis in terms of patient survival (Schaubel et al., 1995; Wolfe et al., 1999; Rabbat et al., 2000). However, there are tens of thousands more patients in need of a kidney transplant than there are available donor kidneys. As a result, patients typically begin renal replacement therapy with dialysis, and those deemed medically suitable are placed on a wait list for transplant. Once on the wait list, a patient may later be removed if his or her health condition declines to the point where transplant surgery is considered futile. In the United States, deceased-donor kidneys are allocated on a first-come firstserved basis. Patients on the wait list move toward the top of the list when patients above them on the list die, receive a transplant, or are removed.
