Outcomes Analysis of U.S. Transplant Centers Performing High Volumes of Hard to Place Kidneys

Y. Qazi¹, D. Bahl², N. Mehta³, Z. Haddad⁴, M. Smogorzewski⁴

¹USC, Los Angeles, CA, ²UC Davis, Sacramento, CA, ³UC Berkeley, Berkeley, CA, ⁴Keck Medical Center At USC, Los Angeles, CA

Meeting: 2019 American Transplant Congress

Abstract number: D369

Keywords: Allocation, High-risk, Kidney transplantation, Outcome

Session Information

Session Name: Poster Session D: Late Breaking

Session Type: Poster Session

Date: Tuesday, June 4, 2019

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

*Purpose: Despite a growing number of patients awaiting a kidney transplant, discard rate remains significantly high. The UNOS SRTR data now provides information on all centers about Hard-to-Place Kidneys, which by definition are allografts allocated and transplanted after initial 100 offers . Our study is an outcomes analysis study of centers that perform high volumes of HTPK.

*Methods: SRTR data for all active US kidney transplant center’s was analyzed to identify centers likely to accept HTPK. Of these programs, High Volume HTPK centers were defined as ones that performed more than a 30 such transplants/year and their patient and graft survivals were noted. The time period for number of Tx performed was 7/1/17 to 6/30/18 and outcomes analysis from 7/1/15 to 12/31/17.

*Results: A total of 1632 HTPK were transplanted in this time period. Only 17/226 (7.5 %) of all U.S. Tx centers performed high volume HTPK centers but accounted for 960/1632 (60%) of such Tx. 12/17 (70.5%) had outcomes as expected , 4/17 (23%) had below expected outcomes and 1/17 (5%)had outcomes above expected. 93.80 to 100 % patients were alive with a functioning graft. When analyzing HTPK center locations by UNOS regions , Region 9; 6/17 (35%), Region 5: 5/17 (29%), Region 4 : 2/17(11%) while Regions 2,3,8 and 11 each had 1 center(5%). 52% of HTPK centers were located in NY and CA.

*Conclusions: Our study demonstrates that only 7.5 % of all U.S Tx centers are high volume utilizers of HTPK. Our study locates over half of such centers in 2 states. 75 % of the HTPK centers had acceptable outcomes and best practice at these centers are being captured by our ongoing study. As new organ allocation policies are formulated, center preferences need to be captured in more granularity to identify centers likely to accept a HTPK. Our study suggests when new allocation policies are formulated, algorithms be considered specifically for organs likely to be classified as HTPK and center experience be factored. Expedited offers to such centers would increase the utilization and reduce discard.

To cite this abstract in AMA style:

Qazi Y, Bahl D, Mehta N, Haddad Z, Smogorzewski M. Outcomes Analysis of U.S. Transplant Centers Performing High Volumes of Hard to Place Kidneys [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/outcomes-analysis-of-u-s-transplant-centers-performing-high-volumes-of-hard-to-place-kidneys/. Accessed June 27, 2025.

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