Evidence map›Paper›PMID 30801530›Full record

ArticleTransplantation2019

Outcomes After Declining Increased Infectious Risk Kidney Offers for Pediatric Candidates in the United States.

Mary G Bowring, Kyle R Jackson, Heather Wasik, Alicia Neu, Jacqueline Garonzik-Wang, Christine Durand, Niraj Desai, Allan B Massie, Dorry L Segev

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Transplantation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. 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 · 2020
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Mary G BowringDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Kyle R JacksonDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Heather WasikDivision of Pediatric Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD.
Alicia NeuDivision of Pediatric Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD.
Jacqueline Garonzik-WangDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Christine DurandDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Niraj DesaiDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Allan B MassieDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Dorry L SegevDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Johns Hopkins Medicine · USJohns Hopkins University · US

Funding

RENAL DISEASE EPIDEMIOLOGY TRAINING GRANTT32DK007732 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI CREWS, DEIDRA CANDICE · 1995 to 2024
$7.7M
Patient Oriented Research in Solid Organ TransplantationK24AI144954 · NIAID · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI SEGEV, DORRY L. · 2020 to 2024
$956k
Patient Oriented Research in Kidney Disease and Transplant SurgeryK24DK101828 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI SEGEV, DORRY L. · 2014 to 2018
$922k
Optimal Antiretroviral Therapy During Bone Marrow Transplant in HIV-1 InfectionK23CA177321 · NCI · JOHNS HOPKINS UNIVERSITY · PI DURAND, CHRISTINE MARIE · 2014 to 2018
$808k
Determinants of chronic kidney disease in African-American live kidney donorsK01DK101677 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI MASSIE, ALLAN B · 2015 to 2019
$789k
Aggressive Center Report Cards to Safely Increase Transplantation of Suboptimal KidneysK23DK115908 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI GARONZIK WANG, JACQUELINE M · 2018 to 2021
$516k
Differential Survival Benefit of Incompatible Living Donor Kidney Transplantation: Modeling Outcomes for Different Patient PhenotypesF32DK113719 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI JACKSON, KYLE R · 2017 to 2019
$238k
NCI NIH HHS K23 CA177321NIAID NIH HHS K24 AI144954NIDDK NIH HHS F32 DK113719NIDDK NIH HHS K01 DK101677NIDDK NIH HHS K23 DK115908NIDDK NIH HHS K24 DK101828NIDDK NIH HHS T32 DK007732
6 · The paper itself

Abstract

backgroundKidneys from infectious risk donors (IRD) confer substantial survival benefit in adults, yet the benefit of IRD kidneys to pediatric candidates remains unclear in the context of high waitlist prioritization.

methodsUsing 2010-2016 Scientific Registry of Transplant Recipients data, we studied 2417 pediatric candidates (age <18 y) who were offered an IRD kidney that was eventually used for transplantation. We followed candidates from the date of first IRD kidney offer until the date of death or censorship and used Cox regression to estimate mortality risk associated with IRD kidney acceptance versus decline, adjusting for age, sex, race, diagnosis, and dialysis time.

resultsOver the study period, 2250 (93.1%) pediatric candidates declined and 286 (11.8%) accepted an IRD kidney offer; 119 (41.6%) of the 286 had previously declined a different IRD kidney. Cumulative survival among those who accepted versus declined the IRD kidney was 99.6% versus 99.4% and 96.3% versus 97.8% 1 and 6 years post decision, respectively (P = 0.1). Unlike the substantial survival benefit seen in adults (hazard ratio = 0.52), among pediatric candidates, we did not detect a survival benefit associated with accepting an IRD kidney (adjusted hazard ratio: 0.791.723.73, P = 0.2). However, those who declined IRD kidneys waited a median 9.6 months for a non-IRD kidney transplant (11.2 mo among those <6 y, 8.8 mo among those on dialysis). Kidney donor profile index (KDPI) of the eventually accepted non-IRD kidneys (median = 13, interquartile range = 6-23) was similar to KDPI of the declined IRD kidneys (median = 16, interquartile range = 9-28).

conclusionsUnlike in adults, IRD kidneys conferred no survival benefit to pediatric candidates, although they did reduce waiting times. The decision to accept IRD kidneys should balance the advantage of faster transplantation against the risk of infectious transmission.

Indexed as

RegistriesTransplant RecipientsWaiting ListsAdolescentChildDonor SelectionFemaleHumansInfectionsKidney TransplantationMaleRetrospective StudiesRisk AssessmentRisk FactorsSurvival RateTissue and Organ Procurement

Identifiers

PMID30801530
PMCPMC6690800
OpenAlexW2920563054

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.