Kidney Exchange Match Rates in a Large Multicenter Clearinghouse
| Autor: | Allan B. Massie, Eric K.H. Chow, Sandra R. DiBrito, Kyle R. Jackson, Dorry L. Segev, Amy D. Waterman, Sommer E. Gentry, Christine E. Haugen, Carlin Purcell, Jacqueline M. Garonzik Wang, Courtenay M. Holscher, Alvin G. Thomas, Matthew Ronin |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Tissue and Organ Procurement Kidney Paired Donation donors and donation 030232 urology & nephrology nephrology kidney transplantation kidney transplantation/nephrology 030230 surgery clinical research/practice Medical and Health Sciences Article ABO incompatibility 03 medical and health sciences 0302 clinical medicine Internal medicine panel reactive antibody (PRA) medicine Living Donors Immunology and Allergy Humans Pharmacology (medical) living donor [kidney transplantation] Registries Transplantation Kidney business.industry panel reactive antibody Histocompatibility Testing Panel reactive antibody paired exchange [donors and donation] Middle Aged health services and outcomes research Kidney Transplantation Confidence interval Alternative treatment practice Deceased donor transplantation medicine.anatomical_structure clinical research Surgery Female Living donor transplantation business |
| Zdroj: | Holscher, CM; Jackson, K; Chow, EKH; Thomas, AG; Haugen, CE; DiBrito, SR; et al.(2018). Kidney exchange match rates in a large multicenter clearinghouse. AMERICAN JOURNAL OF TRANSPLANTATION, 18(6), 1510-1517. doi: 10.1111/ajt.14689. UCLA: Retrieved from: http://www.escholarship.org/uc/item/9td04620 American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, vol 18, iss 6 |
| DOI: | 10.1111/ajt.14689. |
| Popis: | Kidney paired donation (KPD) can facilitate living donor transplantation for candidates with an incompatible donor, but requires waiting for a match while experiencing the morbidity of dialysis. The balance between waiting for KPD vs desensitization or deceased donor transplantation relies on the ability to estimate KPD wait times. We studied donor/candidate pairs in the National Kidney Registry (NKR), a large multicenter KPD clearinghouse, between October 2011 and September 2015 using a competing-risk framework. Among 1894 candidates, 52% were male, median age was 50 years, 66% were white, 59% had blood type O, 42% had panel reactive antibody (PRA)>80, and 50% obtained KPD through NKR. Median times to KPD ranged from 2 months for candidates with ABO-A and PRA 0, to over a year for candidates with ABO-O or PRA 98+. Candidates with PRA 80-97 and 98+ were 23% (95% confidence interval , 6%-37%) and 83% (78%-87%) less likely to be matched than PRA 0 candidates. ABO-O candidates were 67% (61%-73%) less likely to be matched than ABO-A candidates. Candidates with ABO-B or ABO-O donors were 31% (10%-56%) and 118% (82%-162%) more likely to match than those with ABO-A donors. Providers should counsel candidates about realistic, individualized expectations for KPD, especially in the context of their alternative treatment options. |
| Databáze: | OpenAIRE |
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