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Clinical Epidemiology
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Kidney Transplant Outcomes for Prior Living Organ Donors

Vishnu Potluri, Meera N. Harhay, F. Perry Wilson, Roy D. Bloom and Peter P. Reese
JASN May 2015, 26 (5) 1188-1194; DOI: https://doi.org/10.1681/ASN.2014030302
Vishnu Potluri
*Department of Medicine, Lankenau Medical Center, Wynnewood, Pennsylvania;
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Meera N. Harhay
†Renal-Electrolyte and Hypertension Division, Perelman School of Medicine,
‡Department of Biostatistics and Epidemiology, and
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F. Perry Wilson
§Department of Medicine, Yale School of Medicine, New Haven, Connecticut
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Roy D. Bloom
†Renal-Electrolyte and Hypertension Division, Perelman School of Medicine,
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Peter P. Reese
†Renal-Electrolyte and Hypertension Division, Perelman School of Medicine,
‡Department of Biostatistics and Epidemiology, and
‖Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania; and
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Abstract

The Organ Procurement and Transplantation Network gives priority in kidney allocation to prior live organ donors who require a kidney transplant. In this study, we analyzed the effect of this policy on facilitating access to transplantation for prior donors who were wait-listed for kidney transplantation in the United States. Using 1:1 propensity score–matching methods, we assembled two matched cohorts. The first cohort consisted of prior organ donors and matched nondonors who were wait-listed during the years 1996–2010. The second cohort consisted of prior organ donors and matched nondonors who underwent deceased donor kidney transplantation. During the study period, there were 385,498 listings for kidney transplantation, 252 of which were prior donors. Most prior donors required dialysis by the time of listing (64% versus 69% among matched candidates; P=0.24). Compared with matched nondonors, prior donors had a higher rate of deceased donor transplant (85% versus 33%; P<0.001) and a lower median time to transplantation (145 versus 1607 days; P<0.001). Prior donors received higher-quality allografts (median kidney donor risk index 0.67 versus 0.90 for nondonors; P<0.001) and experienced lower post-transplant mortality (hazard ratio, 0.19; 95% confidence interval, 0.08 to 0.46; P<0.001) than matched nondonors. In conclusion, these data suggest that prior organ donors experience brief waiting time for kidney transplant and receive excellent-quality kidneys, but most need pretransplant dialysis. Individuals who are considering live organ donation should be provided with this information because this allocation priority will remain in place under the new US kidney allocation system.

  • kidney transplantation
  • epidemiology
  • outcomes
  • live donors
  • Copyright © 2015 by the American Society of Nephrology
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Journal of the American Society of Nephrology: 26 (5)
Journal of the American Society of Nephrology
Vol. 26, Issue 5
May 2015
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Kidney Transplant Outcomes for Prior Living Organ Donors
Vishnu Potluri, Meera N. Harhay, F. Perry Wilson, Roy D. Bloom, Peter P. Reese
JASN May 2015, 26 (5) 1188-1194; DOI: 10.1681/ASN.2014030302

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Kidney Transplant Outcomes for Prior Living Organ Donors
Vishnu Potluri, Meera N. Harhay, F. Perry Wilson, Roy D. Bloom, Peter P. Reese
JASN May 2015, 26 (5) 1188-1194; DOI: 10.1681/ASN.2014030302
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More in this TOC Section

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  • Kidney Biopsy Features Most Predictive of Clinical Outcomes in the Spectrum of Minimal Change Disease and Focal Segmental Glomerulosclerosis
  • Transplantation Mediates Much of the Racial Disparity in Survival from Childhood-Onset Kidney Failure
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