TY - JOUR
T1 - Association between changes in Membership and Professional Standards Committee review criteria and use of higher-risk kidneys for transplant
AU - Wey, Andrew
AU - Salkowski, Nicholas
AU - Carrico, Robert J.
AU - Shepherd, Sharon
AU - Kasiske, Bertram L.
AU - Thompson, Bryn
AU - Israni, Ajay K.
AU - Snyder, Jon J.
N1 - Publisher Copyright:
Published 2020. This article is a U.S. Government work and is in the public domain in the USA
PY - 2020/7/1
Y1 - 2020/7/1
N2 - The Organ Procurement and Transplantation Network's Membership and Professional Standards Committee implemented an operational rule on March 1, 2017, intended to increase the number of kidneys transplanted from donors with kidney donor profile index (KDPI) ≥ 85% into recipients with poor estimated posttransplant survival (≥ 80%). Using data from the Scientific Registry of Transplant Recipients, ordinal and logistic regressions estimated, respectively, differences in kidney yield (number of transplanted kidneys per recovered donor) and offer acceptance practices before and after implementation. We included donors recovered January 1, 2016-February 28, 2018. The odds of higher kidney yield for donors with KDPI ≥ 85% were 27% higher after implementation (odds ratio, 1.061.271.53), but odds were also 20% higher for donors with KDPI < 85% (1.041.201.38). Thus, kidney yield was higher for all donors, with a slightly larger difference for donors with KDPI ≥ 85%. Additionally, the difference in offer acceptance before and after implementation was similar regardless of KDPI (KDPI < 85%, 0.971.021.07; KDPI ≥ 85%, 0.951.041.14). In the first year after implementation, kidney yield increased for donors with KDPI < and ≥ 85%. Thus, kidney yield from higher KDPI donors may have increased without the operational rule.
AB - The Organ Procurement and Transplantation Network's Membership and Professional Standards Committee implemented an operational rule on March 1, 2017, intended to increase the number of kidneys transplanted from donors with kidney donor profile index (KDPI) ≥ 85% into recipients with poor estimated posttransplant survival (≥ 80%). Using data from the Scientific Registry of Transplant Recipients, ordinal and logistic regressions estimated, respectively, differences in kidney yield (number of transplanted kidneys per recovered donor) and offer acceptance practices before and after implementation. We included donors recovered January 1, 2016-February 28, 2018. The odds of higher kidney yield for donors with KDPI ≥ 85% were 27% higher after implementation (odds ratio, 1.061.271.53), but odds were also 20% higher for donors with KDPI < 85% (1.041.201.38). Thus, kidney yield was higher for all donors, with a slightly larger difference for donors with KDPI ≥ 85%. Additionally, the difference in offer acceptance before and after implementation was similar regardless of KDPI (KDPI < 85%, 0.971.021.07; KDPI ≥ 85%, 0.951.041.14). In the first year after implementation, kidney yield increased for donors with KDPI < and ≥ 85%. Thus, kidney yield from higher KDPI donors may have increased without the operational rule.
KW - kidney transplantation
KW - kidney yield
KW - Membership and Professional Standards Committee
KW - offer acceptance
KW - Organ Procurement and Transplantation Network
KW - regulatory review
UR - http://www.scopus.com/inward/record.url?scp=85084133821&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85084133821&partnerID=8YFLogxK
U2 - 10.1111/ctr.13872
DO - 10.1111/ctr.13872
M3 - Article
C2 - 32271964
AN - SCOPUS:85084133821
SN - 0902-0063
VL - 34
JO - Clinical Transplantation
JF - Clinical Transplantation
IS - 7
M1 - e13872
ER -