Kidney accelerated placement project: Outcomes and lessons learned

Area of Science:

• Nephrology
• Transplantation Surgery
• Organ Procurement

Background:

• A significant number of recovered kidneys, especially those of lower quality, are not utilized for transplantation.
• The Organ Procurement and Transplantation Network (OPTN) Organ Center faces challenges in allocating difficult-to-place kidneys.

Purpose of the Study:

• To evaluate the effectiveness of an accelerated placement pathway in increasing the utilization of kidneys managed by the OPTN Organ Center.
• To determine if offering high kidney donor profile index kidneys to accepting programs improves transplant rates.

Main Methods:

• The Kidney Accelerated Placement (KAP) project was implemented from July 2019 to July 2020.
• Compared OPTN kidney match run, donor, and transplant recipient data from the KAP period with the preceding year.
• Analyzed the acceptance and conversion rates of KAP-eligible donors.

Main Results:

• No statistically significant change in the acceptance rate of KAP-eligible donors was observed (16.4% during KAP vs. 17.5% prior year).
• Conversion from acceptance to transplant showed a non-significant increase under KAP (72.7% vs. 71.2%).

Conclusions:

• An accelerated placement strategy, when initiated after multiple local and regional declines, may be too late to significantly boost kidney utilization.
• Improving transplant rates for nationally shared and marginal quality kidneys remains a challenge, necessitating further investigation of innovative approaches.