Evidence map›Paper›PMID 35372855›Full record

ArticleKidney3602020

Can Behavioral Research Improve Transplant Decision-Making? A Mock Offer Study on the Role of Kidney Procurement Biopsies.

Darren Stewart, Brian Shepard, John Rosendale, Harrison McGehee, Isaac Hall, Gaurav Gupta, Kunam Reddy, Bertram Kasiske, Kenneth Andreoni, David Klassen

Open access · diamondAbstract read
In one paragraph

Article in Kidney360, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
1.4field-weighted citation impact, top 17% 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

10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Article
  4. The early impacts of an attempt to standardize kidney procurement biopsy practices.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2025
    Article
  5. 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 · 2025
    Article
  6. Article
  7. Deceased donor kidneys from higher distressed communities are significantly less likely to be utilized for transplantation.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2023
    Article
  8. Article
  9. Article
  10. 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

10 authors at 5 institutions in 1 country.

Darren StewartResearch Department, United Network for Organ Sharing, Richmond, Virginia.ORCID 0000-0002-6764-4842
Brian ShepardChief Executive Officer, United Network for Organ Sharing, Richmond, Virginia.
John RosendaleResearch Department, United Network for Organ Sharing, Richmond, Virginia.
Harrison McGeheeResearch Department, United Network for Organ Sharing, Richmond, Virginia.
Isaac HallDivision of Nephrology and Hypertension, Department of Internal Medicine, University of Utah School of Medicine, University of Utah, Salt Lake City, Utah.
Gaurav GuptaDivision of Nephrology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia.
Kunam ReddyDivision of Transplant and Hepatobiliary Surgery, Mayo Clinic, Phoenix, Arizona.
Bertram KasiskeHennepin Healthcare Research Institute, Scientific Registry of Transplant Recipients, and Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota; and.
Kenneth AndreoniDepartment of Surgery, University of Florida, Gainesville, Florida.
David KlassenChief Executive Officer, United Network for Organ Sharing, Richmond, Virginia.
Hennepin Healthcare Research Institute · USUniversity of Florida · USUniversity of Utah · USVirginia Commonwealth University · USWinnMed · US

Funding

Vascular Health and Risk Factors in Children with Down SyndromeKL2TR002539 · NCATS · UNIVERSITY OF UTAH · PI MURTAUGH, MAUREEN A, NYGAARD, INGRID E · 2018 to 2022
$4.3M
NCATS NIH HHS KL2 TR002539
6 · The paper itself

Abstract

Background: The use of procurement biopsies for assessing kidney quality has been implicated as a driver of the nearly 20% kidney discard rate in the United States. Yet in some contexts, biopsies may boost clinical confidence, enabling acceptance of kidneys that would otherwise be discarded. We leveraged a novel organ offer simulation platform to conduct a controlled experiment isolating biopsy effects on offer acceptance decisions. Methods: Between November 26 and December 14, 2018, 41 kidney transplant surgeons and 27 transplant nephrologists each received the same 20 hypothetical kidney offers using a crossover design with weekend "washout" periods. Mini-study 1 included four, low serum creatinine (<1.5 mg/dl) donor offers with arguably "poor" biopsy findings that were based on real offers that were accepted with successful 3-year recipient outcome. For each of the four offers, two experimental variants-no biopsy and "good" biopsy-were also sent. Mini-study 2 included four AKI offers with no biopsy, each having an offer variant with "good" biopsy findings. Results: Among low serum creatinine donor offers, we found approximately threefold higher odds of acceptance when arguably poor biopsy findings were hidden or replaced with good biopsy findings. Among AKI donor offers, we found nearly fourfold higher odds of acceptance with good biopsy findings compared with no biopsy. Biopsy information had profound but variable effects on decision making: more participants appeared to have been influenced by biopsies to rule out, versus rule in, transplantable kidneys. Conclusions: The current use of biopsies in the United States appears skewed toward inducing kidney discard. Several areas for improvement, including reducing variation in offer acceptance decisions and more accurate interpretation of findings, have the potential to make better use of scarce, donated organs. Offer simulation studies are a viable research tool for understanding decision making and identifying ways to improve the transplant system.

Indexed as

Behavioral ResearchTissue and Organ ProcurementBiopsyDonor SelectionHumansKidneyRetrospective StudiesUnited Statesacute kidney injuryAcute Kidney Injury and ICU Nephrologybehavioral researchbiopsyChronic Kidney DiseaseCreatinineCross-Over Studiesdecision-makingdiscardkidney transplantationNephrologistsorgan offersSurgeonsTissue and Organ ProcurementTransplantation

Identifiers

PMID35372855
PMCPMC8808489
OpenAlexW3000665483

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.