Publications by authors named "A Leichtman"
Article Synopsis
- Deceased donors (DDs) could increase the number of kidney transplants by participating in kidney paired donation (KPD) chains instead of directly donating to a waitlist candidate, allowing for more transplants overall.
- Researchers used data from 2016-2017 to simulate KPD strategies, addressing concerns about potential disadvantages for blood type O candidates.
- Implementing these strategies could potentially increase annual kidney transplants by up to 290, benefiting all blood types, including highly sensitized and blood type O candidates.
Over the past 65 years, kidney transplantation has evolved into the optimal treatment for patients with kidney failure, dramatically reducing suffering through improved survival and quality of life. However, access to transplant is still limited by organ supply, opportunities for transplant are inequitably distributed, and lifelong transplant survival remains elusive. To address these persistent needs, the National Kidney Foundation convened an expert panel to define an agenda for future research.
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- Kidney disease is a widespread and costly condition, with a new national system (VA-REINS) set up to track and analyze chronic kidney disease (CKD) among US veterans.
- In fiscal year 2014, 1.1 million veterans were identified with CKD using strict definitions, and 2.5 million with more lenient criteria, revealing significant prevalence among VA users.
- The VA invested around $18 billion in CKD care, largely for patients at stage 3, and aims to use VA-REINS for better disease management and improved patient care quality.
As proof of concept, we simulate a revised kidney allocation system that includes deceased donor (DD) kidneys as chain-initiating kidneys (DD-CIK) in a kidney paired donation pool (KPDP), and estimate potential increases in number of transplants. We consider chains of length 2 in which the DD-CIK gives to a candidate in the KPDP, and that candidate's incompatible donor donates to theDD waitlist. In simulations, we vary initial pool size, arrival rates of candidate/donor pairs and (living) nondirected donors (NDDs), and delay time from entry to the KPDP until a candidate is eligible to receive a DD-CIK.
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