Introduction: The medical community is facing a constant shortage of kidneys for transplant patients. The most effective way to combat the deficit is to increase live donor kidney transplants (LDKT) via KPD. We examined whether a higher volume of KPD transplants leads to an increase in the total number of transplants at the center in subsequent years.

Methods: A center-level panel data on KPD, LDKT, deceased donor transplants between 2012 and 2016 were obtained from the SRTR. The final data included 5 year observations of 165 transplant centers that performed at least 1 LDKT during the study period (n = 5 x 165 = 825). The fixed effects model was used for the panel analysis based on Durbin–Wu–Hausman tests (p<0.001). It addresses the potential bias caused by the center level heterogeneity. The regression tested the association between the total number of transplants and the ratio of KPD to living donor transplants, and incorporated up to 2-year lag terms. The association between the number of new waitlist registrants and the KPD ratio was tested to see whether the higher relative volume of KPD transplants promotes registrations.

Results: The mean and the median of the KPD transplants were 3.59 and 1.2 respectively. The distribution was fairly skewed with only 5 transplant centers performing, on average, 20+ KPD transplants per year (s.d. = 5.88, kurtosis = 16.61). The mean and the median KPD ratios were 0.54 and 0.11. The total number of transplants was not associated with the KPD ratio of the same year (b= -.425, p= 0.662) as well as that of 2 prior years (p=0.830 and p=0.629 for one-year and two-year lags respectively). The result of the bivariate regression between the total number of transplants and the KPD ratio was also similar (b= -.5.3, p=0.557). The number of new waitlist registrations was not correlated with the KPD ratio of the same year (b= 501, p= 0.851) as well as that of 2 prior years (p=0.792 and p=0.816 for one-year and two-year lags respectively).

Conclusion: The emphasis on KPD transplants as part of LDKT does not seem to increase the total number of transplants or the number of new waitlist registrations at the center level. This may be due to the fact that the majority of transplant centers currently performs less than 2 KPD transplants per year, thereby limiting the overall growth in the number of transplants and new registrations.

CITATION INFORMATION: Rees M., Michelin E., Koizumi N., Ortiz J. Evaluation of KPD: Does It Improve Overall Transplant Center Performance? Am J Transplant. 2017;17 (suppl 3).

« Back to 2018 American Transplant Congress