Effect of match-run frequencies on the number of transplants and waiting times in kidney exchange.
Am J Transplant
; 18(5): 1177-1186, 2018 05.
Article
em En
| MEDLINE
| ID: mdl-29087017
ABSTRACT
Numerous kidney exchange (kidney paired donation [KPD]) registries in the United States have gradually shifted to high-frequency match-runs, raising the question of whether this harms the number of transplants. We conducted simulations using clinical data from 2 KPD registries-the Alliance for Paired Donation, which runs multihospital exchanges, and Methodist San Antonio, which runs single-center exchanges-to study how the frequency of match-runs impacts the number of transplants and the average waiting times. We simulate the options facing each of the 2 registries by repeated resampling from their historical pools of patient-donor pairs and nondirected donors, with arrival and departure rates corresponding to the historical data. We find that longer intervals between match-runs do not increase the total number of transplants, and that prioritizing highly sensitized patients is more effective than waiting longer between match-runs for transplanting highly sensitized patients. While we do not find that frequent match-runs result in fewer transplanted pairs, we do find that increasing arrival rates of new pairs improves both the fraction of transplanted pairs and waiting times.
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Base de dados:
MEDLINE
Assunto principal:
Algoritmos
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Obtenção de Tecidos e Órgãos
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Teste de Histocompatibilidade
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Transplante de Rim
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Doadores Vivos
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Seleção do Doador
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article