Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: On 12/4/14, the Organ Procurement and Transplantation Network (OPTN) implemented a new Kidney Allocation System (KAS). To maintain pediatric priority, KAS gave pediatric candidates priority for kidneys with a Kidney Donor Profile Index (KDPI) less than 35, whereas previously pediatric candidates received priority for kidneys from donors less than 35 years of age. With 4 years of post-KAS data available, this study examines the impact on pediatric kidney candidates/recipients at a deeper level than has been done previously.
*Methods: This study used data from the OPTN; multi-organ listings and transplants were excluded. Deceased donor transplant, waitlist mortality, and DR mismatch (MM) rates were assessed pre- (12/4/2010-12/3/2014) and post-KAS (12/4/2014-12/3/2018) for pediatrics overall and by age group (0-5, 6-10, 11-17). The KDPI distribution of pediatric kidney donors by age group was assessed post-KAS.
*Results: Deceased donor transplant rates for the 0-5 year old candidates significantly decreased post-KAS to 96.9 (95% Confidence Interval (CI): 87.9, 106.7) from 119.1 (CI: 107.9, 131.1) pre-KAS; the 11-17 year old age group saw a significant increase to 120.0 (CI: 113.8, 126.4) post-KAS vs. 102.3 (CI: 97.0, 107.7) pre-KAS (Figure 1A). Waitlist mortality rates decreased post-KAS vs. pre-KAS for all but the 11-17 age group, where they remained similar (Figure 1B). DR MM rates for 6-10 year old age group significantly increased post-KAS vs. pre-KAS (93.5% vs. 89.2%, p = 0.048), and remained similar for the 0-5 (93.7% vs. 93.4%, p = 0.862) and 11-17 year old age groups (92.1% vs. 91.2%, p = 0.456). Less than 1% of 0-5 year old donors, 32.3% of 6-10 year old donors, and 90.5% of 11-17 year old donors had a KDPI less than 35 post-KAS. Post-KAS, children received 8.3% of all pediatric deceased donor kidneys vs. 11.3% pre-KAS.
*Conclusions: Pediatric recipients are currently not prioritized for KDPI 35-100% kidneys, while many pediatric deceased donors have a KDPI greater than 35. Future changes to kidney allocation policy should continue to consider the impact to pediatric candidates.
To cite this abstract in AMA style:Foutz J, Smith J, Wilk A, Vakili K, Mazariegos G, Bartosh S. Four Years of KAS: A Pediatric Specific Report [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/four-years-of-kas-a-pediatric-specific-report/. Accessed May 5, 2021.
« Back to 2020 American Transplant Congress