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Kidney Week

Abstract: PO2486

Kidney Offer Calculator: The Risk of Accepting an Offer vs. Waiting for a Better Offer

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Chen, Shan Shan, University of New Mexico, Albuquerque, New Mexico, United States
  • Litvinovich, Igor, University of New Mexico, Albuquerque, New Mexico, United States
  • Kataria, Ashish, University of New Mexico, Albuquerque, New Mexico, United States
  • Zhu, Yiliang, University of New Mexico, Albuquerque, New Mexico, United States
  • Argyropoulos, Christos, University of New Mexico, Albuquerque, New Mexico, United States
  • Ng, Yue-Harn, University of Washington, Seattle, Washington, United States
Background

Currently, no tools exist to facilitate patients with decisions to accep or refuse an offer. Using the scientific registry of transplant recipients database, we formulated a risk calculator for allograft failure and patient mortality risk (if offer accepted) vs. mortality risk if the patient refused.

Methods

Using a multi-state model approach, we created multiple competing risk models for: 1) first kidney offer or dying on wait-list without any offer; 2) if offer is refused, the probability of a) receiving a transplant vs. b) death and 3) if an offer is accepted, the probability of a) allograft failure vs. b) death. All models were adjusted for candidate estimated post-transplant survival (EPTS) score while allograft failure and patient survival was adjusted for recipient EPTS, donor KDPI and cold ischemic time.

Results

Fig.1 shows our multi-state model for which the competing risk models were build. Table 1 depicts the hazard ratio for each stage described above and the kidney offer risk calculator created using the estimates generated from the models. We included a case scenario to demonstrate how the calculator works (Table 1).

Conclusion

In summary, creating a risk calculator is feasible. Next, we will refine our calculator to account for repeated offers and include other variables that may affect allograft offer and survival e.g. panel reactive antibody.