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    Accelerating Kidney Allocation: Simultaneously Expiring Offers

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    Name:
    Mankowski_et_al-2019-American_Journal_of_Transplantation.pdf
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    Description:
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    Type
    Article
    Authors
    Mankowski, Michal A
    Kosztowski, Martin
    Raghavan, Subramanian
    Garonzik-Wang, Jacqueline M
    Axelrod, David
    Segev, Dorry L
    Gentry, Sommer E
    KAUST Department
    Computer, Electrical and Mathematical Sciences and Engineering (CEMSE) Division
    Date
    2019-05-28
    Permanent link to this record
    http://hdl.handle.net/10754/631994
    
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    Abstract
    Placing non-ideal kidneys quickly might reduce discard. We studied changing kidney allocation to eliminate sequential offers, instead making offers to multiple centers for all non-locally allocated kidneys, so that multiple centers must accept or decline within the same one hour. If more than one center accepted an offer, the kidney would go to the highest-priority accepting candidate. Using 2010 KPSAM-SRTR data, we simulated the allocation of 12,933 kidneys, excluding locally allocated and zero-mismatch kidneys. We assumed that each hour of delay decreased the probability of acceptance by 5%, and that kidneys would be discarded after 20 hours of offers beyond the local level. We simulated offering kidneys simultaneously to small, medium, and large batches of centers. Increasing the batch size increased the percentage of kidneys accepted and shortened allocation times. Going from small to large batches increased the number of kidneys accepted from 10,085 (92%) to 10,802 (98%) for low-KDPI, and from 1,257 (65%) to 1,737 (89%) for high-KDPI kidneys. The average number of offers a center received each week was 10.1 for small batches and 16.8 for large batches. Simultaneously expiring offers might allow faster allocation and decrease the number of discards, while still maintaining an acceptable screening burden. This article is protected by copyright. All rights reserved.
    Citation
    Mankowski MA, Kosztowski M, Raghavan S, Garonzik-Wang JM, Axelrod D, et al. (2019) Accelerating Kidney Allocation: Simultaneously Expiring Offers. American Journal of Transplantation. Available: http://dx.doi.org/10.1111/ajt.15396.
    Sponsors
    This work was supported by grant number R01DK111233 from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Michal A. Mankowski was supported by King Abdullah University of Science and Technology (KAUST). Martin Kosztowski was supported by National Institute of Diabetes, Digestive, and Kidney Diseases (T32DK007732). The data reported here have been supplied by the Hennepin Healthcare Research Institute (HHRI) as the contractor for the Scientific Registry of Transplant Recipients (SRTR). The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy of or interpretation by the SRTR, UNOS/OPTN, or the US Government.
    Publisher
    Wiley
    Journal
    American Journal of Transplantation
    DOI
    10.1111/ajt.15396
    Additional Links
    https://onlinelibrary.wiley.com/doi/abs/10.1111/ajt.15396
    ae974a485f413a2113503eed53cd6c53
    10.1111/ajt.15396
    Scopus Count
    Collections
    Articles; Computer, Electrical and Mathematical Science and Engineering (CEMSE) Division

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