Estimated Post Transplant Survival Allocation: Not Just Better Kidneys, but Faster Ones as Well
1Georgetown University School of Medicine, Washington, DC, 2Medstar Georgetown Transplant Institute, Washington, DC
Meeting: 2019 American Transplant Congress
Abstract number: A202
Keywords: Allocation, Waiting lists
Session Information
Session Name: Poster Session A: Kidney Deceased Donor Allocation
Session Type: Poster Session
Date: Saturday, June 1, 2019
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall C & D
*Purpose: Since 2014 the Kidney Allocation System (KAS) has used estimated post-transplant survival (EPTS) scores and longevity matching to prioritize patients with the best EPTS to receive kidneys with the longest expected survival. We quantified the independent effect of this allocation advantage on waiting times.
*Methods: We conducted a retrospective analysis of 396 consecutive deceased donor kidney transplants at our center beginning December 4, 2014 ( the implementation of KAS) using data from the UNOS DonorNet® to determine waiting time and priority group for each transplant. The groups were defined by the priority in which the organ was ultimately allocated. Standard recipients were those who received organs in the general allocation pools (local, regional, and national; blood type identical or permissible). The low EPTS group included those patients who received kidneys in the 0-20% EPTS (local or regional) allocation pool.
*Results: There were 228 patients who received kidneys in the standard priority groups. A further 13 patients received kidneys in the low EPTS priority group. Wait times at transplant were significantly shorter for recipients in the low EPTS group compared to standard recipients across the A, B, and O blood groups. There were no low EPTS patients in the AB blood group.
| Number | Mean Waiting Time (years) | % Change from Standard Group | |
| Blood Type A — Standard | 73 | 6.20 | |
| Blood Type A — Low EPTS | 7 | 3.74 | – 39.5 |
| Blood Type B — Standard | 52 | 6.91 | |
| Blood Type B — Low EPTS | 3 | 4.47 | – 35.3 |
| Blood Type O — Standard | 103 | 7.51 | |
| Blood Type O — Low EPTS | 3 | 6.28 | – 16.3 |
| Overall Low EPTS | – 33.3 |
*Conclusions: The use of longevity matching was designed to provide an advantage in kidney quality for patients with the best EPTS scores. While some shortening of waiting time was anticipated, the magnitude of the reduction in waiting time has not been previously reported. With waits averaging 1/3 shorter than for standard recipients at our center, this allocation priority provides an additional independent advantage to these recipients which is often overlooked.
To cite this abstract in AMA style:
Ormiston L, Vranic G, Moore J, Thomas B, Cooper M, Gilbert A. Estimated Post Transplant Survival Allocation: Not Just Better Kidneys, but Faster Ones as Well [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/estimated-post-transplant-survival-allocation-not-just-better-kidneys-but-faster-ones-as-well/. Accessed November 22, 2024.« Back to 2019 American Transplant Congress