http://unos.org/about/index.php?topic=newsroom&article_id=2872UNOS Researchers Present Studies at World Transplant Congress
San Francisco -- United Network for Organ Sharing (UNOS) staff members authored and will present several studies at the World Transplant Congress (WTC), held July 26-31 at the Moscone West Convention Center. UNOS staff members are primary authors of a total of 11 abstracts and are coauthors of an additional 13 abstracts.
Exploring the Candidate/Donor Compatibility Matrix to Identify Opportunities to Improve the OPTN KPD Pilot Program’s Priority Point Schedule
Authors: Darren Stewart, M.S.*, Ruthanne Leishman, RN, M.P.H., CPTC*, Anna Kucheryavaya, M.S.*, Richard Formica, M.D., Mark Aeder, M.D., Adam Bingaman, M.D., Sommer Gentry, Ph.D., Tuomas Sandholm, Ph.D., Itai Ashlagi, Ph.D.
The OPTN Kidney Paired Donation Pilot Program (KPDPP) arranges matches for living donor kidney transplants from a pool of potential donors and candidates when an intended donor-candidate pair are not biologically compatible. The researchers studied results from the computer algorithm used in the KPDPP to identify the types of patients that are easier or harder to match. They also assessed whether adjustments could be made to generate more matches, especially for patients who are difficult to match. Candidates with very high immune system sensitization (a CPRA score of approximately 95 percent or higher) were found to be substantially harder to match. They may benefit from a “sliding scale” approach to prioritization, as opposed to the current approach that awards the same number of points for all candidates with a CPRA of 80 percent or higher. The level of specificity that transplant programs place on matching criteria (for example, whether they would accept a left or right kidney) also affected the number of possible matches generated. Prioritization based on characteristics of donor-candidate pairs (as opposed to candidates only) may increase matching opportunities, as would further increases in the pool of potential donors and candidates entered into the KPDPP.
Improvement in Follow-up Reporting for Living Kidney Donors since Implementation of New OPTN Policy
Authors: Jennifer Wainright, Ph.D.*, Maureen McBride, Ph.D.*, Mary Amanda Dew, Ph.D., Claudine Lougee, B.A.*, Lee Bolton, M.S.N., ACNP*, Christie Thomas, M.B., FRCP, FASN, FAHA
In February 2013, the OPTN implemented minimum thresholds for living donor kidney transplant programs to report clinical and laboratory follow-up data on their donors. This information is important to assess potential donor risk and aid in informed consent for living kidney donation. The researchers studied comparable cohorts of follow-up data before and after the thresholds were established.
National rates of timely clinical data increased from 59.1 percent prior to policy implementation to 65.7 percent after implementation. Timely submission of lab data similarly increased, from 48 percent before implementation to 58.8 percent afterward. Few reports indicated that living kidney donors were unwilling to submit to follow-up. The transplant volume of the individual program was not a factor in the amount of timely reporting; both large and small programs achieved high follow-up reporting rates. Timely reporting should continue to improve as transplant programs continue to learn more about how to meet the new requirements.
The OPTN Kidney Paired Donation Pilot Program (KPDPP): Reaching the Tipping Point in 2013
Authors: Ruthanne Leishman, RN, M.P.H., CPTC*, Darren Stewart, M.S.*, Catherine Monstello, RRT, CPHQ*, Wida Cherikh, Ph.D.*, Tuomas Sandholm, Ph.D., Richard Formica, M.D., Mark Aeder, M.D.
The authors reviewed progress in the OPTN Kidney Paired Donation Pilot Program (KPDPP) from its launch in 2010 through November 2013. In that time, 133 living donor kidney transplant programs nationwide had agreed to participate in the program, with 92 having entered at least one potential donor-recipient pair for matching. Transplants arranged through the program increased by 420 percent between 2012 and 2013 (10 and 52 transplants, respectively). This is associated with increases in both the number of matches identified by the system and the match success rate – the proportion of matches that led to a successful transplant (from 3 percent in 2012 to 10 percent in 2013).
Nearly two-thirds of the transplant candidates entered into the matching system had high immune system sensitization (CPRA of 80 percent or above), which greatly limits the possibility of finding a compatible match. Nevertheless, the KPDPP has been very successful in matching these candidates; nearly 30 percent of the recipients transplanted in the study period were highly sensitized. More than one-third of the recipients were ethnic minorities.
The KPDPP is overseen by a work group that continues to work on ways to increase the success rate of matches and provide additional transplant opportunities to candidates through the increasingly successful program.
Topic: UNOS Researchers at World Transplant Congress: KPD & Living Donor Follow up (Read 2519 times)