A Working Group formed by The Transplantation Society of Australia and New Zealand (TSANZ) has recently been developing and testing designs for a new Australian kidney allocation algorithm, with the aim of producing more equitable outcomes for patients as well as an increase in the number of life years saved from kidney transplantation. Between February and April 2025, a proposed new algorithm was presented to 23 consumers (8 currently on the waiting list, 15 who had received a kidney) for their feedback on its objectives, design, and outcomes. Consumers were identified by reaching out to TSANZ consumer representatives and the consumer engagement teams of the Australian and New Zealand Society of Nephrology (ANZSN), Transplant Australia, Kidney Health Australia and Diabetes Australia. Consumers were interviewed in small group sessions of one to six participants, during which they were asked open-ended questions and invited to give unstructured feedback. The major theme that emerged from the consultations was an imperative for greater system transparency, including (i) more information about how the kidney allocation system works and how the algorithm prioritises matches, (ii) a better explanation of the nature of the waiting list, (iii) more accurate estimates of waiting times, and (iii) more proactive communication with patients while they are on the waiting list that includes personalised information on allocation rankings. Participants were in support of the objectives of the redesign and of changes that would make the system fairer for all but noted the importance of monitoring any system changes for unintended consequences.
