1. Australian deceased donor kidney allocation protocols: Transplant waiting and graft quality for children and adolescents.
- Author
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Le Page AK, Johnstone LM, and Kennedy SE
- Subjects
- Adolescent, Australia, Child, Child, Preschool, Clinical Protocols, Female, Humans, Infant, Infant, Newborn, Kaplan-Meier Estimate, Male, Proportional Hazards Models, Quality Assurance, Health Care, Time Factors, Tissue Donors statistics & numerical data, Tissue and Organ Procurement organization & administration, Tissue and Organ Procurement statistics & numerical data, Health Services Accessibility statistics & numerical data, Healthcare Disparities statistics & numerical data, Kidney Failure, Chronic surgery, Kidney Transplantation standards, Patient Selection, Tissue and Organ Procurement standards, Waiting Lists
- Abstract
DD kidney allocation protocols may influence timing of transplantation and graft quality for pediatric recipients. This study aimed to evaluate the effects of these protocols, including pediatric priority, on waiting time on dialysis, transplant type, donor age, and HLA matching according to state of transplant in Australia. De-identified information on patients <15 yr of age who commenced RRT in NSW, Qld, and Victoria from 2002 to 2011 was retrieved from the ANZDATA. Transplant type, donor age, and HLA mismatching were compared between states, with competing risk regression used to examine the time to transplant. There were significant differences in waiting time to DD transplantation between the three states. Children in NSW and Qld waited a median of 14 and 11 months vs. 21 months in Victoria. The ratio of LD to DD transplants was lower in NSW and Qld. Differences correlated with DD pediatric priority in NSW and Qld. DDs in NSW were older than in the other states. HLA matching did not differ. DD kidney allocation protocols with pediatric priority in Australian states were associated with shorter waiting times and increased DD proportion., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2015
- Full Text
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