Kidney accelerated placement project: Outcomes and lessons learned,American Journal of Transplantation

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Kidney accelerated placement project: Outcomes and lessons learned
American Journal of Transplantation ( IF 8.9 ) Pub Date : 2021-09-28 , DOI: 10.1111/ajt.16859
Samantha M Noreen ₁ , David Klassen ₁ , Roger Brown ₁ , Yolanda Becker ₂ , Kevin O'Connor ₃ , Jennifer Prinz ₄ , Matthew Cooper ₅

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Opportunities continue to be lost with a high rate of kidneys recovered for transplant but not utilized, particularly those considered less than ideal quality. The Organ Procurement and Transplantation Network (OPTN) Organ Center is tasked with allocating arguably the most difficult-to-place kidneys, and we hypothesized an accelerated placement pathway would increase utilization of kidneys placed by the Organ Center. The Kidney Accelerated Placement (KAP) project, implemented by the Organ Center from July 18, 2019 to July 15, 2020, aimed to offer kidneys with a high kidney donor profile index to programs that had a history of accepting such organs. We compared OPTN kidney match run, donor, and transplant recipient data during the project period and 1 year prior. There was no statistically significant change in the percentage of KAP-eligible donors accepted during the project period (16.4%) compared to the prior year (17.5%). Conversion from acceptance to transplant was higher under KAP (72.7% vs. 71.2%), though not significant. Waiting to accelerate placement after kidneys have been declined by multiple transplant programs locally and regionally is an intervention that may come too late to effectively increase utilization. Transplant rates of nationally shared and marginal kidneys remain a challenge, and future iterations of this project should be investigated.

中文翻译：

肾脏加速放置项目：结果和经验教训

机会继续丧失，用于移植但未被利用的肾脏恢复率很高，特别是那些被认为质量不理想的肾脏。器官采购和移植网络 (OPTN) 器官中心的任务是分配可以说是最难放置的肾脏，我们假设加速放置途径将增加器官中心放置的肾脏的利用率。器官中心于 2019 年 7 月 18 日至 2020 年 7 月 15 日实施的肾脏加速放置 (KAP) 项目旨在为具有接受此类器官历史的项目提供具有高肾脏供体概况指数的肾脏。我们比较了项目期间和 1 年前的 OPTN 肾脏匹配运行、供体和移植受体数据。与上一年 (17.5%) 相比，项目期间接受的符合 KAP 资格的捐助者百分比 (16.4%) 没有统计上的显着变化。在 KAP 下，从接受到移植的转化率更高（72.7% 对 71.2%），但并不显着。在当地和区域多个移植计划减少肾脏后等待加速放置是一种可能来不及有效提高利用率的干预措施。全国共享和边缘肾脏的移植率仍然是一个挑战，应该调查该项目的未来迭代。在当地和区域多个移植计划减少肾脏后等待加速放置是一种可能来不及有效提高利用率的干预措施。全国共享和边缘肾脏的移植率仍然是一个挑战，应该调查该项目的未来迭代。在当地和区域多个移植计划减少肾脏后等待加速放置是一种可能来不及有效提高利用率的干预措施。全国共享和边缘肾脏的移植率仍然是一个挑战，应该调查该项目的未来迭代。

更新日期：2021-09-28

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