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

Increased Graft Survival Following Implementation of the Kidney Allocation Score

M. L. Samoylova1, B. I. Shaw1, W. Irish2, S. J. Kesseli1, A. Connor1, A. S. Barbas1, L. McElroy1, K. V. Ravindra1

1Surgery, Duke University Hospital, Durham, NC, 2Surgery, East Carolina University, Greenville, NC

Meeting: 2020 American Transplant Congress

Abstract number: B-017

Keywords: Allocation, Graft failure, Kidney, Outcome

Session Information

Session Name: Poster Session B: Kidney Deceased Donor Allocation

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: The Kidney Allocation Score (KAS) was developed to improve matching of donor and recipients; we examine the effect of this change on transplantation practice and outcomes.

*Methods: Data from the UNOS STAR files was used to identify first-time adult of a deceased donor kidney-alone transplant pre-KAS (Jan 2011-Dec 2014) and post-KAS (Jan 2015-Dec 2017). Demographic variables were summarized and compared for donor and recipient. Patient and graft survival were compared by Kaplan-Meier log-rank test. Cumulative incidence function was used to estimate the probability of graft loss with death as a competing event. Follow-up was truncated to 24 months.

*Results: 26,612 transplants were performed pre-KAS, and 30,701 post-KAS. Compared to pre-KAS, post-KAS donors were younger, less likely to have diabetes or hypertension, and more likely to die of anoxic brain injury. Compared to pre-KAS, post-KAS gender and ethnic disparities narrowed with more female and African-American recipients. Recipients were also more likely to be diabetic, and had a higher calculated percent reactive antibody (cPRA) (Table 1). Post-KAS, kidneys were more likely to experience cold ischemia time > 24 hours (20.0% vs 18.8%, p<0.001) and to be procured after cardiac death (21.5% vs 17.8%, p<0.001). Correspondingly, post-KAS kidneys had greater delayed graft function, defined by requiring hemodialysis within the first week post-transplant (28.7% vs 26.1%, p<0.001). Patient survival did not change post-KAS (KM log rank p=0.296). Competing risks modeling demonstrated a lower hazard of graft loss post-KAS, HR 0.90 (95% CI 0.84-0.97, p=0.007). Cumulative incidence function of graft loss is presented in Figure 2.

*Conclusions: Implementation of the KAS has allowed the use of higher-quality kidneys in younger, more sensitized recipients. Despite an increase in transplants for highly sensitized recipients, KA has resulted in a 10% reduction in hazard of graft loss. Longer follow-up and attention to organ discard practices are needed to quantify the long-term impact of the KAS system.

Table 1. Donor and recipient characteristics.
Pre-KAS

(n=26,612)
Post-KAS

(n=30,701)
p-value
Donor age > 60, n(%) 2,292 (8.6%) 2,299 (7.5%) <0.001
Donor Diabetes, n(%) 2,168 (8.2%) 2,171 (7.1%) <0.001
Donor Cause of Death, n(%)

Anoxia
Stroke
Head Trauma
CNS Tumor
Other
8,632 (32.4%)
8,251 (31.0%)
8,872 (33%)
134 (0.5%)
723 (2.7%)
12,603 (41.1%)
7,783 (25.4%)
9,333 (30.4%)
116 (0.4%)
866 (2.8%)
<0.001
KDPR>85%, n(%) 2,272 (8.5%) 2,228 (7.3%) <0.001
Recipient Age > 60, n(%) 9,869 (37.1%) 10,462 (34.1%) <0.001
cPRA, Mean (SD) 16.9 (30.3) 19.5 (33.1) <0.001
cPRA>80%, n(%) 2,617 (9.8%) 3,640 (11.9%) <0.001

 border=

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Samoylova ML, Shaw BI, Irish W, Kesseli SJ, Connor A, Barbas AS, McElroy L, Ravindra KV. Increased Graft Survival Following Implementation of the Kidney Allocation Score [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/increased-graft-survival-following-implementation-of-the-kidney-allocation-score/. Accessed May 11, 2025.

« Back to 2020 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