How to Transplant more Kidneys

Will the organ shortage crisis in the USA ever be abetted? What efforts are transplant centers, organ procurement organizations (OPO), and regulatory bodies doing in order to transplant more kidneys? We found the top 5 ways to increase the number of successful kidney transplants:

  1. Recover more kidneys - Not all eligible deaths are recognized and donation potential can be lost. Living donation can increase with better incentives, however, living donation rates are declining.
  2. Incentivize aggressive transplant centers - Even the lowest quality kidneys, highest KDPI kidneys (>90%), provide a survival benefit to waiting patients.
  3. Make critical decisions faster - Getting to a decision faster will allow more candidates to be considered for transplant before the organ expires. Transplant centers currently are afforded ~60mins to review an organ offer but regulatory efforts to hasten this process have reduced this to ~30mins in 2018. Communication among OPO, recovery, and transplant teams must be collaborative, succinct, and accurate.
  4. Avoid the weekends - The decision-makers are professionals but they fallible in all the ways any human can be. We are prone to deadly decision-making biases that result in poor clinical decisions. Weekend effects are present in all industries and transplantation is not immune. Learn more about clinical decision support algorithms and AI to help transplantation decisions.
  5. Pump it up, you got to pump it up - Using a kidney preservation pump increases the chances of transplant success. The savings associated with minimizing delayed graft function which can exceed the cost of pumping.

 

About the author:

Eric Pahl is a Ph.D. candidate at the University of Iowa School of Health Informatics, CoFounder & CTO of HealthTech Solutions, and a leading innovator in the application of artificial intelligence and machine learning to organ transplantation and the intelligent assistance of surgeons and organ procurement professionals.

Reese, P. P., Harhay, M. N., Abt, P. L., Levine, M. H., & Halpern, S. D. (2016). New Solutions to Reduce Discard of Kidneys Donated for Transplantation. Journal of the American Society of Nephrology, 27(4), 973–980. https://doi.org/10.1681/ASN.2015010023

Stewart, D. E., Garcia, V. C., Rosendale, J. D., Klassen, D. K., & Carrico, B. J. (2017). Diagnosing the Decades-Long Rise in the Deceased Donor Kidney Discard Rate in the United States, 101(3). https://doi.org/10.1097/TP.0000000000001539

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