BACKGROUND: Outcomes on the kidney transplant waiting list vary markedly by region and patient characteristics, and the new kidney allocation system (KAS) changed the probability of transplant for many groups. We created a calculator to predict candidates' likely outcomes on the waiting list under the new KAS.

METHODS: Data were obtained from the US Scientific Registry of Transplant Recipients. The retrospective cohort included 87,795 first-time adult candidates on the deceased donor kidney transplant waiting list between June 1, 2016, and February 28, 2017, censored at transfer to another program, living donor transplant, or 15 years from listing. Predictors included transplant program or donation service area (DSA), age, sex, race / ethnicity, calculated panel-reactive antibodies, dialysis time, blood type, body mass index, and comorbid conditions, with a parsimonious model favored for clinical utility. Outcomes were deceased donor transplant, death or removal from the waiting list, or continuing to wait. To account for competing risks, the modeled cause-specific hazards were used to predict the cumulative incidence of each outcome.

RESULTS: C-statistics ranged from 0.67 to 0.75 and good calibration was demonstrated with calibration plots. The probabilities of transplant, death or removal from the list, or continuing to wait are shown at 3, 5, and 7 years of follow-up, and include an option to show program-specific or DSA-level predictions (Figure 1).

CONCLUSION: Since the new KAS, the probability of deceased donor transplant changed for many groups. The updated kidney waitlist calculator provides an individualized prediction of likely outcomes for transplant candidates, helping candidates make informed decisions about treatment options.

CITATION INFORMATION: Hart A., Salkowski N., Matas A., Kasiske B., Snyder J., Israni A. A Calculator for Kidney Transplant Waitlist Outcomes under the New Kidney Allocation System Am J Transplant. 2017;17 (suppl 3).

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