ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Changes in Kidney Offer Acceptance for Pediatric Candidates Post-KAS

M. Bowring, K. Jackson, J. Garonzik-Wang, D. Segev, A. Massie

Johns Hopkins University, Baltimore, MD

Meeting: 2019 American Transplant Congress

Abstract number: 14

Keywords: Allocation, Kidney transplantation, Pediatric

Session Information

Session Name: Concurrent Session: Kidney Deceased Donor Allocation I

Session Type: Concurrent Session

Date: Sunday, June 2, 2019

Session Time: 2:30pm-4:00pm

 Presentation Time: 2:54pm-3:06pm

Location: Ballroom B

*Purpose:

Stakeholders have expressed concerns regarding kidney transplant rates for pediatric candidates under KAS. To better understand what might be driving potential declines in access, we studied offer patterns and acceptance practices before and after KAS.

*Methods:

We used SRTR kidney offer data to study 5300 active pediatric kidney-only transplant candidates on the waitlist between 10/31/2012-1/6/2017. We used negative binomial regression and multilevel logistic regression to estimate offer rates per person-year and compare the odds of accepting an offer in the 2 years before and after KAS (12/4/2014) adjusting for candidate age, sex, race, dialysis time, preemptive listing, and secular trends. Given changes in prioritization for pediatric candidates under KAS, we studied kidney offers of adult and pediatric donors with KDPI above and below 35.

*Results:

Pre-KAS, 7,925 offers were made to 1,632 candidates, and 984 (12.4%) were accepted. Post-KAS, 9,926 offers were made to 1,723 candidates, and 1,052 (10.6%) were accepted; the number of donors remained unchanged at 2,879 and 2,917 pre- and post-KAS. The offer rate increased from 10.0 to 14.7 per person-year post-KAS for kidneys overall, 6.1 to 12.4 per person-year for adult-donor kidneys with KDPI<35, and 1.2 to 1.6 per person-year for pediatric-donor kidneys with KDPI<35 (Table 1A, Figure 1). Among pediatric candidates who received an offer, however, the odds of acceptance decreased 21% post-KAS for adult-donor kidneys with KDPI<35 (aOR 0.620.790.99, p=0.047) and increased 1.7-fold for pediatric-donor kidneys with KDPI<35 (aOR 1.021.722.88, p=0.04) (Table 1B). Acceptance of adult and pediatric donor kidneys with KDPI≥35 remained unchanged post-KAS (p-values>0.1).

*Conclusions:

Pediatric candidates received more low-KDPI kidney offers from adult donors under KAS, yet offer acceptance declined. High prioritization of pediatric candidates might allow for increased selectivity, but the decision to decline an offer should be weighed against the consequences of remaining on dialysis for these patients.

 border=

 border=

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

To cite this abstract in AMA style:

Bowring M, Jackson K, Garonzik-Wang J, Segev D, Massie A. Changes in Kidney Offer Acceptance for Pediatric Candidates Post-KAS [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/changes-in-kidney-offer-acceptance-for-pediatric-candidates-post-kas/. Accessed June 1, 2025.

« Back to 2019 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences