Using Linked Health Service Data in Multimodal Modeling of Kidney Transplant Waitlist Outcomes: Protocol for the...

Area of Science:

• Organ transplantation research
• Biostatistics and health economics
• Public health policy

Background:

• Increasing deceased organ donation is crucial globally but limited by biovigilance concerns (cancer/infectious disease transmission).
• Up to 60% of potential Australian organ donors are declined due to biovigilance issues, impacting transplant rates.

Purpose of the Study:

• To evaluate the impact of accepting or declining potential deceased organ donors (due to biovigilance concerns) on patient and transplant outcomes.
• To analyze factors affecting kidney transplant waitlist journeys and quantify delays caused by donor offer declines.

Main Methods:

• Utilizing binational registry data (Australia/New Zealand, 2010-2020) for waitlisted patients and referred donors.
• Employing flexible parametric survival models to assess time from offer decline to transplantation and impact of disadvantage.
• Developing health economic models to simulate costs, quality-adjusted survival, and transplant times based on varying donor acceptance strategies.

Main Results:

• Data analysis is ongoing, with results anticipated for dissemination in 2025.
• Linked health data for the study were received in 2023.
• Study aims to quantify potential donor gains through improved risk assessment and threshold adjustments.

Conclusions:

• The MODUS study will provide evidence on the effects of increasing acceptance of deceased donor kidneys declined for biovigilance reasons.
• Expected outcomes include improved patient survival, quality of life, and cost-effectiveness of an "informed biovigilance strategy".
• Findings aim to support policy decisions in organ donation and transplantation with global relevance.