Journal article
Accelerating kidney allocation: Simultaneously expiring offers
American journal of transplantation, Vol.19(11), pp.3071-3078
11/01/2019
DOI: 10.1111/ajt.15396
PMCID: PMC6812592
PMID: 31012528
Abstract
Using nonideal kidneys for transplant quickly might reduce the discard rate of kidney transplants. We studied changing kidney allocation to eliminate sequential offers, instead making offers to multiple centers for all nonlocally allocated kidneys, so that multiple centers must accept or decline within the same 1 hour. If more than 1 center accepted an offer, the kidney would go to the highest-priority accepting candidate. Using 2010 Kidney-Pancreas Simulated Allocation Model-Scientific Registry for Transplant Recipients data, we simulated the allocation of 12 933 kidneys, excluding locally allocated and zero-mismatch kidneys. We assumed that each hour of delay decreased the probability of acceptance by 5% and that kidneys would be discarded after 20 hours of offers beyond the local level. We simulated offering kidneys simultaneously to small, medium-size, and large batches of centers. Increasing the batch size increased the percentage of kidneys accepted and shortened allocation times. Going from small to large batches increased the number of kidneys accepted from 10 085 (92%) to 10 802 (98%) for low-Kidney Donor Risk Index kidneys and from 1257 (65%) to 1737 (89%) for high-Kidney Donor Risk Index kidneys. The average number of offers that a center received each week was 10.1 for small batches and 16.8 for large batches. Simultaneously expiring offers might allow faster allocation and decrease the number of discards, while still maintaining an acceptable screening burden.
Details
- Title: Subtitle
- Accelerating kidney allocation: Simultaneously expiring offers
- Creators
- Michal A. Mankowski - King Abdullah University of Science and TechnologyMartin Kosztowski - Johns Hopkins MedicineSubramanian Raghavan - University of Maryland, College ParkJacqueline M. Garonzik-Wang - Johns Hopkins MedicineDavid Axelrod - Roy J. and Lucille A. Carver College of MedicineDorry L. Segev - Johns Hopkins MedicineSommer E. Gentry - United States Naval Academy
- Resource Type
- Journal article
- Publication Details
- American journal of transplantation, Vol.19(11), pp.3071-3078
- DOI
- 10.1111/ajt.15396
- PMID
- 31012528
- PMCID
- PMC6812592
- NLM abbreviation
- Am J Transplant
- ISSN
- 1600-6135
- eISSN
- 1600-6143
- Publisher
- Wiley
- Number of pages
- 8
- Grant note
- T32DK007732 / NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) T32 DK007732; R01 DK111233 / NIDDK NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK)
- Language
- English
- Date published
- 11/01/2019
- Academic Unit
- Surgery
- Record Identifier
- 9984322804402771
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