ArticleJournal of the American Society of Nephrology : JASN2020
Major Variation across Local Transplant Centers in Probability of Kidney Transplant for Wait-Listed Patients.
Article in Journal of the American Society of Nephrology : JASN, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
45 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Health insurance and kidney transplantation outcomes in the United States: a systematic review and AI-driven analysis of disparities in access and survival.Renal failure · 2025Pooled it
- Factors influencing the acceptance of deceased donor kidney transplant offers in children-a vignette survey.Clinical kidney journal · 2026Article
- Metrics That Matter: Evaluating the Correlates of Pretransplant Performance in US Kidney Transplant Programs.Kidney international reports · 2026Article
- Association between Rurality and Evaluation Start among Referred Patients with End-Stage Kidney Disease.American journal of nephrology · 2026Article
- Engaging Dialysis Teams in Shared Decision-Making Conversations With Patients to Improve Rates of Kidney Transplantation.Kidney medicine · 2026Article
- Outcomes of Deceased Donor Kidney Transplants Allocated Out of Sequence in the United States.Clinical journal of the American Society of Nephrology : CJASN · 2026Observational
- Eligibility, timing, and organ quality: indications and outcomes of kidney transplantation in older patients.Kidney international · 2026Review
- Regional Variation in Early Kidney Transplant Access Across Dialysis Facilities in 4 US Regions.Kidney international reports · 2026Article
- Quantifying Center-level Aggressiveness in Transplanting Suboptimal, Deceased Donor Kidneys in the United States.Transplantation direct · 2026Article
- Out-of-Sequence Placement of Deceased Donor Kidneys Is Exacerbating Inequities in the United States.Clinical journal of the American Society of Nephrology : CJASN · 2026Article
- Acceptance of High Kidney Donor Profile Index Kidneys Among Consented Candidates.Kidney international reports · 2025Article
- Association between out-of-sequence allocation and deceased donor kidney nonuse across organ procurement organizations.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2025Article
- Decreasing efficiency in deceased donor kidney offer notifications under the new distance-based kidney allocation system.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2025Article
- Scientific advances in the assessment, modification, and generation of transplantable organs for patients with end-stage organ diseases.Lancet (London, England) · 2025Review
- Policy innovations to advance equity in solid organ transplantation.Lancet (London, England) · 2025Review
- The dynamics of deceased donor kidney transplant decision making: insights from studying individual clinicians' offer decisions.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2025Article
- Left Ventricular Ejection Fraction and Previous Cardiac Revascularization: Impact on Patient Survival, Graft Survival, and Complications in Kidney Transplant Recipients.Transplantation direct · 2025Article
- Transforming transplantation access: A federal directive for comprehensive pre-waitlisting data collection.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2025Article
- Equity and the operational considerations of the kidney transplant allocation system.Current opinion in organ transplantation · 2025Review
- Outcomes for Patients With a Deceased Donor Kidney Offer in the New Allocation System.Kidney international reports · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundGeographic disparities in access to deceased donor kidney transplantation persist in the United States under the Kidney Allocation System (KAS) introduced in 2014, and the effect of transplant center practices on the probability of transplantation for wait-listed patients remains unclear.
methodsTo compare probability of transplantation across centers nationally and within donation service areas (DSAs), we conducted a registry study that included all United States incident adult kidney transplant candidates wait listed in 2011 and 2015 (pre-KAS and post-KAS cohorts comprising 32,745 and 34,728 individuals, respectively). For each center, we calculated the probability of deceased donor kidney transplantation within 3 years of wait listing using competing risk regression, with living donor transplantation, death, and waiting list removal as competing events. We examined associations between center-level and DSA-level characteristics and the adjusted probability of transplant.
resultsCandidates received deceased donor kidney transplants within 3 years of wait listing more frequently post-KAS (22%) than pre-KAS (19%). Nationally, the probability of transplant varied 16-fold between centers, ranging from 4.0% to 64.2% in the post-KAS era. Within DSAs, we observed a median 2.3-fold variation between centers, with up to ten-fold and 57.4 percentage point differences. Probability of transplantation was correlated in the post-KAS cohort with center willingness to accept hard-to-place kidneys (
conclusionsLarge differences in the adjusted probability of deceased donor kidney transplantation persist under KAS, even between centers working with the same local organ supply. Probability of transplantation is significantly associated with organ offer acceptance patterns at transplant centers, underscoring the need for greater understanding of how centers make decisions about organs offered to wait-listed patients and how they relate to disparities in access to transplantation.
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