Evidence map›Paper›PMID 31343577›Full record

ArticleTransplantation2019

National Variation in Increased Infectious Risk Kidney Offer Acceptance.

Courtenay M Holscher, Mary G Bowring, Christine E Haugen, Sheng Zhou, Allan B Massie, Sommer E Gentry, Dorry L Segev, Jacqueline M Garonzik Wang

Abstract read
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 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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

5 citing papers in PubMed.

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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

8 authors.

Courtenay M HolscherDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Mary G BowringDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Christine E HaugenDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Sheng ZhouDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Allan B MassieDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Sommer E GentryDepartment of Mathematics, United States Naval Academy, Annapolis, MD.
Dorry L SegevDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Jacqueline M Garonzik WangDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.

Funding

Reducing geographic disparities in kidney and liver allocationR01DK111233 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI WARREN, DANIEL S · 2016 to 2019
$2.5M
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
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
Trajectory of post-donation renal function in living kidney donorsF32DK109662 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI HOLSCHER, COURTENAY · 2016 to 2018
$232k
Novel Frailty Phenotype in Older Adults with End-Stage Renal DiseaseF32AG053025 · NIA · JOHNS HOPKINS UNIVERSITY · PI HAUGEN, CHRISTINE · 2016 to 2019
$204k
NIAID NIH HHS K24 AI144954NIA NIH HHS F32 AG053025NIDDK NIH HHS F32 DK109662NIDDK NIH HHS K01 DK101677NIDDK NIH HHS K23 DK115908NIDDK NIH HHS K24 DK101828NIDDK NIH HHS R01 DK111233
6 · The paper itself

Abstract

backgroundDespite providing survival benefit, increased risk for infectious disease (IRD) kidney offers are declined at 1.5 times the rate of non-IRD kidneys. Elucidating sources of variation in IRD kidney offer acceptance may highlight opportunities to expand use of these life-saving organs.

methodsTo explore center-level variation in offer acceptance, we studied 6765 transplanted IRD kidneys offered to 187 transplant centers between 2009 and 2017 using Scientific Registry of Transplant Recipients data. We used multilevel logistic regression to determine characteristics associated with offer acceptance and to calculate the median odds ratio (MOR) of acceptance (higher MOR indicates greater heterogeneity).

resultsHigher quality kidneys (per 10 units kidney donor profile index; adjusted odds ratio [aOR], 0.94; 95% confidence interval [CI], 0.92-0.95), higher yearly volume (per 10 deceased donor kidney transplants; aOR, 1.08, 95% CI, 1.06-1.10), smaller waitlist size (per 100 candidates; aOR, 0.97; 95% CI, 0.95-0.98), and fewer transplant centers in the donor service area (per center; aOR, 0.88; 95% CI, 0.85-0.91) were associated with greater odds of IRD acceptance. Adjusting for donor and center characteristics, we found wide heterogeneity in IRD offer acceptance (MOR, 1.96). In other words, if listed at a center with more aggressive acceptance practices, a candidate could be 2 times more likely to have an IRD kidney offer accepted.

conclusionsWide national variation in IRD kidney offer acceptance limits access to life-saving kidneys for many transplant candidates.

Indexed as

AdultAllograftsDonor SelectionFemaleHumansInfectionsKidneyKidney Failure, ChronicKidney TransplantationMaleMiddle AgedPatient Acceptance of Health CarePractice Patterns, Physicians'RegistriesRisk AssessmentRisk Factors

Identifiers

PMID31343577
PMCPMC6703966

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Registered trials

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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.