A Donor Utilization Index to Assess the Utilization and Discard of Deceased Donor Kidneys Perceived as High Risk.

A Donor Utilization Index to Assess the Utilization and Discard of Deceased Donor Kidneys Perceived as High Risk. Clin J Am Soc Nephrol. 2019 Oct 17;: Authors: Brennan C, Husain SA, King KL, Tsapepas D, Ratner LE, Jin Z, Schold JD, Mohan S Abstract BACKGROUND AND OBJECTIVES: An increasing number of patients on the waitlist for a kidney transplant indicates a need to effectively utilize as many deceased donor kidneys as possible while ensuring acceptable outcomes. Assessing regional and center-level organ utilization with regards to discard can reveal regional variation in suboptimal deceased donor kidney acceptance patterns stemming from perceptions of risk. DESIGN, SETTING, PARTICIPANTS, &MEASUREMENTS: We created a weighted donor utilization index from a logistic regression model using high-risk donor characteristics and discard rates from 113,640 deceased donor kidneys procured for transplant from 2010 to 2016, and used it to examine deceased donor kidney utilization in 182 adult transplant centers with>15 annual deceased donor kidney transplants. Linear regression and correlation were used to analyze differences in donor utilization indexes. RESULTS: The donor utilization index was found to significantly vary by Organ Procurement and Transplantation Network region (P
Source: Clinical Journal of the American Society of Nephrology : CJASN - Category: Urology & Nephrology Authors: Tags: Clin J Am Soc Nephrol Source Type: research

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The prevalence of end-stage renal disease (ESRD) and the number of kidney transplants performed continues to rise every year, straining the procurement of deceased and living kidney allografts and health systems. Genome-wide genotyping and sequencing of diseased populations have uncovered genetic contributors in substantial proportions of ESRD patients. A number of these discoveries are beginning to be utilized in risk stratification and clinical management of patients. Specifically, genetics can provide insight into the primary cause of chronic kidney disease (CKD), the risk of progression to ESRD, and post-transplant out...
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This article provides an overview of current findings published in the recent five years regarding the relationship between tacrolimus exposure and variation therein and the development of dnDSA.Expert opinion: In this review we describe how combining data on tacrolimus intra-patient variability and mean pre-dose concentration may be an effective tool to identify kidney transplant recipients who are at higher risk of developing dnDSA. PMID: 31721605 [PubMed - as supplied by publisher]
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Donate Life America is now in partnership with a large dialysis corporation to expand living donor resources for waiting recipients on the kidney transplant list.Medscape Medical News
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AbstractPurpose of ReviewKidney paired donation (KPD), desensitization, and prioritization in the deceased donor kidney allocation system (KAS) are current options to facilitate kidney transplant in difficult-to-match, highly sensitized patients. KPD participation has increased while new desensitization tools are developed. We review these trends and discuss the combined role of desensitization and KPD.Recent FindingsAccording to the National Kidney Registry (NKR), KPD utilizing desensitization decreased while the number of highly sensitized KPD transplants and deceased donor transplants increased over the past decade. Thi...
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