ArticleClinical kidney journal2026
Factors influencing the acceptance of deceased donor kidney transplant offers in children-a vignette survey.
Article in Clinical kidney journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Donor kidneys are allocated to potential pediatric kidney transplant recipients based on criteria such as human leukocyte antigen (HLA) immunology, but explicit guidance for accepting deceased-donor kidney offers is lacking. Methods: A vignette survey was designed with a matrix of 128 fictitious kidney offers consisting of seven dimensions with two levels each: mismatches on HLA A, B, C (≤3/≥4); mismatches on HLA DR, DQ (≤2/≥3); donor estimated glomerular filtration rate (eGFR) (≥50/≤49 ml/min/1.73 m Results: Forty participants from eleven allocation organizations in Europe, Iran, and Canada, most commonly Eurotransplant (58%), including eight European countries, provided 533 evaluations (3-6 per vignette). In the multivariate analysis, four of the seven vignette dimensions decreased acceptance: ≥4 HLA A, B, C mismatches ( Conclusions: This pilot study suggests that factors such as HLA mismatches, donor eGFR, and donor age, consistently guided decisions, independently of participant's allocation organization. This underscores the potential value of developing evidence-informed donor-offer acceptance guidelines and investigating the impact of these factors on kidney transplantation outcome.
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