Allocation of kidneys for transplantation: Practical aspects and ethical dilemmas

Organ allocation is a very dynamic field, but despite ongoing change, there is evidence of inequity of access to transplantation. This overview compares the principles and practical aspects of organ allocation in countries in the Western world, and identifies areas of concern, ongoing changes and future trends. There are significant differences between the approaches adopted by each country and a universally applicable algorithm is elusive. Any new solution may have to achieve a compromise between results and equity issues. New approaches to allocation are currently explored and may herald a new dawn in the allocation of kidneys for transplantation.