ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2018
The kidney allocation system does not appropriately stratify risk of pediatric donor kidneys: Implications for pediatric recipients.
Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Allocation of Kidney Allografts From Donors With Kidney Donor Profile Index <35% and the Impact of Kidney Donor Profile Index Revisions on Access to Transplantation for Children.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2026Article
- Optimizing Kidney Allograft Years: Underutilization of Pediatric Donors.Transplantation direct · 2026Article
- En-bloc kidney transplants from very small pediatric donors: a propensity score matched analysis.Frontiers in pediatrics · 2025Article
- Predicting pediatric kidney transplant wait times: The unexplored landscape and pre-allocation transplant policies.Pediatric nephrology (Berlin, Germany) · 2024Article
- Scoring donor lungs for graft failure risk: The Lung Donor Risk Index (LDRI).American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2024Article
- A modified Kidney Donor Risk Index for pediatric kidney transplant recipients.Pediatric nephrology (Berlin, Germany) · 2023Article
- Organ allocation in pediatric abdominal transplant.Seminars in pediatric surgery · 2022Article
- Pediatric Kidney Transplantation-Can We Do Better? The Promise and Limitations of Epitope/Eplet Matching.Frontiers in pediatrics · 2022Review
- Donor considerations in pediatric kidney transplantation.Pediatric nephrology (Berlin, Germany) · 2021Review
- Changes in offer and acceptance patterns for pediatric kidney transplant candidates under the new Kidney Allocation System.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2020Article
- Transplantation of a single kidney from pediatric donors less than 10 kg to children with poor access to transplantation: a two-year outcome analysis.BMC nephrology · 2020Article
- Eplet mismatch analysis and allograft outcome across racially diverse groups in a pediatric transplant cohort: a single-center analysis.Pediatric nephrology (Berlin, Germany) · 2020Article
- Pediatric deceased donor kidney transplant outcomes under the Kidney Allocation System.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2019Article
- Use of public health service increased risk kidneys in pediatric renal transplant recipients.Pediatric transplantation · 2019Article
- Assessing the discrimination of the Kidney Donor Risk Index/Kidney Donor Profile Index scores for allograft failure and estimated glomerular filtration rate in Ireland's National Kidney Transplant Programme.Clinical kidney journal · 2019Article
- R Open Source Programming Code for Calculation of the Kidney Donor Profile Index and Kidney Donor Risk Index.Kidney diseases (Basel, Switzerland) · 2018Article
- Utilization of Standard Criteria Donor and Expanded Criteria Donor Kidneys After Kidney Allocation System Implementation.Annals of transplantation · 2018Article
- It is time to revise the kidney allocation system to restore the pediatric advantage.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2018Article
- Impact of the kidney allocation system on young pediatric recipients.Clinical transplantation · 2018Article
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Abstract
Kidney Allocation System (KAS) was enacted in 2014 to improve graft utility, while facilitating transplantation of highly-sensitized patients and preserving pediatric access to high-quality kidneys. Central to this system is the Kidney Donor Profile Index (KDPI), a metric intended to predict transplant outcomes based on donor characteristics but derived using only adult donors. We posited that KAS had inadvertently altered the profile and quantity of kidneys made available to pediatric recipients. This question arose from our observation that most pediatric donors carry a KDPI over 35 and have therefore been rendered relatively inaccessible to pediatric recipients under KAS. Here we explore early trends in pediatric transplantation following KAS, including: (i) use of pediatric donors, (ii) use of Public Health System (PHS) high infectious risk donors, (iii) wait time, and (iv) living donor transplantation. We note some concerning preliminary changes following KAS implementation, including the allocation of fewer deceased donor pediatric kidneys to children and stagnation in pediatric wait times. Moreover, the poor predictive power of the KDPI for adult donors appears to be even worse when applied to pediatric donors. These early trends warrant further observation and consideration of changes in pediatric kidney allocation if they persist.
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