Uncontrolled donation after circulatory death improves access to kidney transplantation: A decision analysis

Rashikh A. Choudhury, Kas Prins, Yoeli Dor, Hunter B. Moore, Hillary Yaffe, Trevor L. Nydam

Research output: Contribution to journalArticlepeer-review

Abstract

Aim: Uncontrolled donation after cardiac death (uDCD) remains an underutilized source of kidney allografts in the United States. The objective of this study was to estimate the impact of the implementation of a uDCD program on transplantation rates and long-term survival for patients with end-stage renal disease (ESRD) in the United States. Methods: A decision-analytic Markov state transition model was created using medical decision-making software (DATA 3.5; TreeAge Software, Inc) to estimate the impact of an uDCD program on transplantation rates and patient survival. Additionally, sensitivity analysis of uDCD donor pool increase was modeled. All model statistic parameters were extracted from the literature. Results: A uDCD program increased the rate of transplant at 10 years (37.8%, Accept uDCD group, vs 35.9%, Reject uDCD group). At 10 years, overall survival for Accept uDCD was 55.6% compared to 54.8% in the Reject uDCD. Conclusions: Uncontrolled DCD improves access to transplant for ESRD patients on the kidney transplant waitlist, thereby improving long-term survival.

Original languageEnglish (US)
Article numbere13868
JournalClinical Transplantation
Volume34
Issue number7
DOIs
StatePublished - Jul 1 2020
Externally publishedYes

Keywords

  • kidney transplantation
  • uDCD

ASJC Scopus subject areas

  • Transplantation

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