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Deceased donors has been a potential source of kidneys for our end stage kidney disease patients since 1976 but their numbers had remained low until today. The exponential growth of kidney failure in the country and the low donation rate called for an allocation system that will have to balance the principle of utility and justice as the available kidneys are very scarce and the patients need to wait an average of 15 years to get a kidney.
In 1998, the Malaysian Organ Sharing System (MOSS) was established by the Malaysian Society of Nephrology (MSN) to serve as a standardised list of patients waiting for a deceased donor kidney transplant. On 1st September 2006, an electronic version of MOSS, called eMOSS was officially launched . The patients are listed according to their blood group and states and enables all registered users nationwide to access the list of patients under their care and update their health status from time to time. The rank and position of each patient in the list is auto generated, based on the calculated duration of dialysis treatment entered into the national dialysis database (National Renal Registry) at the time of the initial notification to the Registry. Due to a few technical issues, the only criteria applicable in this system was the waiting time which means the longer a patient on dialysis, they are given priority to receive the kidney.
The current selection process is solely based on the ethical principle of justice (being fair), but not on utility (quality of being fair). Thus, the Malaysia Kidney Allocation System (MyKAS), was introduced to overcome this problem. This approach seeks to achieve the best use of donated organs, avoid futile transplant, promote patient access and promote efficient management of deceased donor kidney transplantation |
