Abstract: TH-PO873
Effect of Kidney Allocation System (KAS) Policy on Renal Transplantation in Elderly Recipients
Session Information
- Transplantation: Donation and Access
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Jatoi, Tahir Ahmed, SUNY Downstate Health Sciences University, New York City, New York, United States
- Sasidharan, Sandeep Raja, SUNY Downstate Health Sciences University, New York City, New York, United States
- Abushawer, Mohammad Waleed, SUNY Downstate Health Sciences University, New York City, New York, United States
- Cabezas, Fausto Ricardo, SUNY Downstate Health Sciences University, New York City, New York, United States
- Gruessner, Angelika C., SUNY Downstate Health Sciences University, New York City, New York, United States
- Saggi, Subodh J., SUNY Downstate Health Sciences University, New York City, New York, United States
- Salifu, Moro O., SUNY Downstate Health Sciences University, New York City, New York, United States
Background
Prior to 2015 KAS policy creation and implementation, there were inordinate number of kidneys being allocated to recipients who were not matched appropriately to enhance the longevity of the transplanted organ. Our aim was to analyze the impact of KAS policy on patient mortality.
Methods
This study includes retrospective analysis of primary DDRT patients age ≥ 65 years reported to UNOS/OPTN and performed between 2010 and 2022. Patients were divided into preKAS and KAS group by dialysis status. Comprehensive univariate and multivariable analyses were performed.
Results
There were 34717 patients analyzed. Fig1 shows the changes in factors over time. The number of transplants increased significantly as well as the number of preemptive transplants. The wait time decreased significantly and the number of Black and Hispanic recipients increased significantly. Fig1 shows patient and graft survival at 3 years. During the KAS era outcomes declined. The analysis showed an increased Relative Risk for transplants during KAS (RR: 1.39,1.32-1.46) while the outcome for preemptive transplants is significantly lower (RR: 0.68,0.64-0.73).
Conclusion
The number of kidney transplants in this elderly transplant group increased over time which offers an increased life-expectancy. While overall the mortality risk could not be reduced, a shorter waitlist time was noted, which is important. This analysis also shows the importance of early transplantation in this age group to reduce mortality.
Fig 1
Fig 2