Association of transplant center market concentration and local organ availability with deceased donor kidney utilization

Husain, S. Ali; King, Kristen L.; Cron, David C.; Neidlinger, Nikole; Ng, Han Seong; Mohan, Sumit; Adler, Joel T.

doi:10.1111/ajt.17010

Cited by 5 publications

(1 citation statement)

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“…This may also open the door to more systematic study of longer, machine perfusion-based methods of storage for kidneys. Finally, many centers are now faced with more competition due to the broader distribution of organs, and it remains to be seen if increased competition will lead centers to be more aggressive with their use of suboptimal quality kidneys [ 33 ].…”

Section: Looking Aheadmentioning

confidence: 99%

The New Distance-Based Kidney Allocation System: Implications for Patients, Transplant Centers, and Organ Procurement Organizations

2022

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Purpose of Review The goal of deceased donor kidney allocation policy is to provide objective prioritization for donated kidneys, and policy has undergone a series of revisions in the past decade in attempt to achieve equity and utility in access to kidney transplantation. Most recently, to address geographic disparities in access to kidney transplantation, the Kidney Allocation System changed to a distance-based allocation system—colloquially termed “KAS 250”—moving away from donor service areas as the geographic basis of allocation. We review the early impact of this policy change on access to transplant for patients, and on complexity of organ allocation and transplantation for transplant centers and organ procurement organizations. Recent Findings Broader sharing of kidneys has increased complexity of the allocation system, as transplant centers and OPOs now interact in larger networks. The increased competition resulting from this system, and the increased operational burden on centers and OPOs resulting from greater numbers of organ offers, may adversely affect organ utilization. Preliminary results suggest an increase in transplant rate overall but a trend toward higher kidney discard and increased cold ischemia time. Summary The KAS 250 allocation policy changed the geographic basis of deceased donor kidney distribution in a manner that is intended to reduce geographic disparities in access to kidney transplantation. Close monitoring of this policy’s impact on patients, transplant center behavior, and process measures is critical to the aim of maximizing access to transplant while achieving transplant equity.

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Section: Looking Aheadmentioning

confidence: 99%