NOA method – three dimensions in the governance of kidney transplantation: Need-Opportunity-Accessibility, how to engage them?

Abstract

Background Despite all efforts, the demand for organs increases. New and better strategies are still needed, critical in a crisis like pandemics. Methodology A mathematical approach that integrates need, Opportunity , and Accessibility to kidney transplantation, was created. NOA method, corresponds to the lateral surface area of a trigonal pyramid with the need, Opportunity , and Accessibility as axis, resulting in an intuitional chart output (NOA chart) and a percentage score (NOA score). Higher NOA scores are associated with larger NOA chart areas. Method Application We found some natural variability among the European Member States regarding Need, Opportunity , and Accessibility to kidney transplantation, concomitant with NOA scores. In 2019, in the European Union, 129 patients pmp on the waiting list for a kidney transplant were registered, 47 kidneys pmp were procured, and 36 kidneys pmp were transplanted, corresponding to 25% of kidney transplantation's response capacity. Conclusion Transplantation is frequently the better treatment for end-stage kidney failure. NOA method may be, in the future, an indicator for evaluating the overall transplantation performance regarding the need for it and a tool for policy definition. With NOA method we seek to contribute for: A transplantation overall performance normalizing score; Transplantation response capacity evaluation.