Abstract: PO2153
Visualizing Waitlist Outcomes for Kidney Transplant Candidates Whose Centers Have Declined Deceased Donor Offers
Session Information
- Transplantation: Clinical - Underrecognized Risk Factors, Traditional Considerations, and Outcomes
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Schaffhausen, Cory, Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States
- Miller, Jon, Chronic Disease Research Group, Minneapolis, Minnesota, United States
- Matas, Arthur J., University of Minnesota Department of Surgery, Minneapolis, Minnesota, United States
- Israni, Ajay K., Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States
- Wey, Andrew, Scientific Registry of Transplant Recipients, Minneapolis, Minnesota, United States
- Hart, Allyson, University of Minnesota Department of Medicine, Minneapolis, Minnesota, United States
Background
While transplant centers closely monitor posttransplant outcomes for each transplant recipient, centers currently lack data to monitor waitlist outcomes of individual candidates. Waiting candidates may receive multiple deceased donor organ offers. Centers may decline offers on behalf of the candidate in order to wait for a better offer. These decisions may impact waitlist outcomes because a better offer may not arrive, and dialysis-related morbidity may worsen. We sought to develop waitlist outcome reports to facilitate monitoring of candidates receiving donor offers.
Methods
A report mockup used patient-level data from the Scientific Registry of Transplant Recipients (SRTR). Data included a deidentified random sample of 200 kidney waitlist candidates from across the United States who had received at least one offer between May 7, 2019 and May 6, 2020. For each candidate, offers were identified from match runs from January 1, 2014 to May 6, 2020. Match run data included any offer that was ultimately accepted somewhere and resulted in a transplant. Offers in the match run after the last accepted offer and multi-listed candidates were excluded.
Results
The report visually identifies several outcomes: candidates who died after receiving offers, additional time on dialysis, and changes to quality and frequency of donor offers over time. Figure 1A depicts multiple patients on a waitlist. Each horizontal row represents one candidate, and each colored cell represents the highest-quality donor offer for each month, indicated by Kidney Donor Profile Index (KDPI).
Conclusion
The waitlist reports are a potential method for centers to self-monitor candidates and may supplement posttransplant outcome monitoring and existing decision support tools such as statistical outcomes calculators. The reports illustrate how offer frequency and KDPI change while candidates wait, as well as candidates’ dialysis burden. Additional research is warranted to evaluate additional relevant candidate and donor data for reports (eg, offer number) and understand the utility of visual representations of the impact of offer decisions made on behalf of waitlist candidates.
Funding
- Other NIH Support