Background: The new kidney allocation system (KAS) was implemented on 12/4/14 and led to more transplants for highly sensitized and long-term dialysis patients. Clinical characteristics of patients transplanted under KAS may influence post-transplant outcomes.

Methods: OPTN data (supplemented with CMS dialysis data) were analyzed for solitary deceased donor adult kidney transplants performed 7-mos pre-KAS (5/1/14-12/3/14) vs. post-KAS (12/4/14-6/30/15) to quantify 1-year post-transplant survival rates per the Kaplan-Meier method. Rates were statistically compared via complementary log-log tests.

Results: Overall, 1-year patient and graft survival was lower but not significantly different pre- vs. post-KAS: 96.8% v. 96.3% [p=0.1889] and 94.3% vs. 93.6% [p=0.0686] respectively.Significant reductions were found for graft survival for KDPI <85 [borderline: CPRA: 1-79, 10+ years dialysis] and patient survival for 10+ years dialysis. No other significant changes were found.Discussion: Post-KAS, 1-year graft survival is over 93%, and 1-year patient survival is over 96%; though slightly lower post-KAS, there were only a couple of significant differences when examining survival by recipient and transplant characteristics. Despite known higher DGF post- vs. pre-KAS, there is little effect on early graft survival. Additionally, there appears to be no decrease in early graft and patient survival for both CPRA 99-100% and KDPI >85 recipients despite wider national and regional sharing prioritization. Further analysis is needed as more data become available to evaluate the effect of KAS as results may be affected by the shifts in recipient characteristics through continued tapering of bolus effects.

CITATION INFORMATION: Wilk A, Stewart D, Aeder M, Kucheryavaya A, Klassen D. One-Year Graft and Patient Survival of Deceased Donor Kidney Transplants Under KAS. Am J Transplant. 2017;17 (suppl 3).

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