The New Kidney Allocation System(KAS) improve access disadvantaged groups. The effect on the elderly population, recipients >=65 is unknown.

Methods: Retrospective analysis of UNOS database preKAS 01/01/2013-12/04/2014 and post KAS 12/4/2016-6/30/2016 for elderly transplant recipients with cadaveric or living donor transplant. Differences in gender, age, race, predialysis transplant rates, primary transplant,wait time, donor age, cold ischemic time, PRA, GFR, KDPI and HLA mismatch.Frequency distribution and significance using chi Square statistic p- value >0.05 controlled for donor types.

Results: Total number 9260. PreKAS 5191, Cadaveric 3919, Living 1272. Post KAS 4082. Cadaveric 2960 living donor 1122. GENDER:preKAS era 63.4% men vs 60.6% cadaveric donors.Living donors: preKAS 69.5 vs 67.7% post KAS.

RACE: Pre vs Post KAS rates. Cadaveric -Whites 55.9 vs 49.7, Black 22.7 vs 27.5.Living Donor-White 78.6 vs 77.2, Blacks 8.1 vs 8.9 p <0.0001

TRANSPLANT #s: Primary transplants- Cadaveric 94.8 vs 93.7 Second transplants 5.0 vs 5.8 Third transplants: 0.15 vs 0.44 . For Living Primary 96.9 vs 96.1, second 2.8 vs 3.8, p value 0.05

PREDIALYSIS: Cadaveric 15.2 vs 10.8, Living 38.1 vs 40.6

DIALYSIS: Cadaveric 84.7 vs 88.9 and Living 61.6 vs 59.3 p <0.0017

Elderly transplanted 2010-2016: 17.9, 18.8, 18.2, 19.1, 20.1% preKAS, and 16.4, 17.6% postKAS.

See

the wait time is shorter in the post KAS period but donor age and other characteristic remain the same.

Conclusion: Elderly Transplants post KAS period have shorter wait times, blacks are transplanted more and less predialysis transplant. More patients are transplanted with second and third kidneys. The new allocation system benefit the elderly transplant patient overall.

CITATION INFORMATION: Whittaker V, Laftavi M, Acun Z, Gruessner R, Gruessner A. The New Kidney Allocation System: The Effect on Elderly Transplantation in the US. Review of UNOS Database. Am J Transplant. 2017;17 (suppl 3).

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