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dc.contributor.authorCalisa, Vaishnavi-
dc.contributor.authorCraig, Jonathan C-
dc.contributor.authorHoward, Kirsten-
dc.contributor.authorHowell, Martin-
dc.contributor.authorAlexander, Stephen-
dc.contributor.authorChadban, Steven J-
dc.contributor.authorClayton, Philip-
dc.contributor.authorLim, Wai H-
dc.contributor.authorKanellis, John-
dc.contributor.authorWyburn, Kate-
dc.contributor.authorJohnson, David W-
dc.contributor.authorMcDonald, Stephen P-
dc.contributor.authorOpdam, Helen I-
dc.contributor.authorChapman, Jeremy R-
dc.contributor.authorYang, Jean-
dc.contributor.authorWong, Germaine-
dc.identifier.citationTransplantation 2018; 102(9): 1530-1537-
dc.description.abstractTo determine the incremental gains in graft and patient survival under a risk-based, deceased donor kidney allocation compared to the current Australian algorithm. Risk-based matching algorithms were applied to first graft, kidney only recipients (n=7513) transplanted in Australia between 1994 and 2013. Probabilistic models were used to compare the waiting time, life and quality-adjusted life years and graft years between the 8 risk-based allocation strategies against current practice. Compared to current practice, KDRI-EPTS matching of the lowest 20% of scores reduced median waiting time by 0.64 years (95% CI: 0.52-0.73) for recipients aged ≤ 30 years, but increased waiting time by 0.94 years (95% CI: 0.79 - 1.09) for recipients aged > 60 years. Among all age groups, the greatest gains occurred if KDRI-EPTS matching of the lowest 30% of scores was used, incurring a median overall gain of 0.63 (95% CI: 0.03-1.25) life years and 0.78 (95% CI: 0.30 - 1.26) graft years compared to current practice. A median gain in survival of 1.91 years for younger recipients (aged 30-45 years) was offset by a median reduction in survival (by 0.95 life years) among the older recipients. Prioritisation of lower quality donor kidneys for older candidates reduced the waiting time for recipients aged > 45 years, but no changes in graft and patient survivals were observed. Risk-based matching engendered a moderate, overall increase in graft and patient survival, accrued through benefits for recipients aged ≤ 45 years but disadvantage to recipients aged > 60 years.-
dc.titleSurvival and quality of life impact of a risk-based allocation algorithm for deceased donor kidney transplantation.-
dc.typeJournal Article-
dc.identifier.affiliationSydney School of Public Heath, The University of Sydney-
dc.identifier.affiliationCentre for Kidney Research, Kid's Research Institute, The Children's Hospital at Westmead-
dc.identifier.affiliationANZDATA Registry, SA Health and Medical Research Institute, Adelaide, Australia-
dc.identifier.affiliationRenal Medicine, Royal Prince Alfred Hospital, Sydney, Australia-
dc.identifier.affiliationKidney Node, Charles Perkins Centre, University of Sydney, Australia-
dc.identifier.affiliationSchool of Medicine, University of Adelaide, Adelaide, Australia-
dc.identifier.affiliationCentral Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, Australia-
dc.identifier.affiliationDepartment of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia-
dc.identifier.affiliationSchool of Medicine and Pharmacology, University of Western Australia, Perth, Australia-
dc.identifier.affiliationDepartment of Nephrology, Monash Health and Centre for Inflammatory Diseases, Department of Medicine, Monash University, Clayton, Victoria, Australia-
dc.identifier.affiliationDepartment of Nephrology, Princess Alexandra Hospital, Brisbane, Australia-
dc.identifier.affiliationCentre for Kidney Disease Research, University of Queensland, Brisbane, Australia-
dc.identifier.affiliationTranslational Research Institute, Brisbane, Australia-
dc.identifier.affiliationAustin Health, Heidelberg, Victoria, Australia-
dc.identifier.affiliationCentre for Transplant and Renal Research, Westmead Hospital-
dc.identifier.affiliationSchool of Mathematics and Statistics, University of Sydney, Australia-
dc.type.austinJournal Article-, Helen I
item.fulltextNo Fulltext-
item.openairetypeJournal Article-
item.languageiso639-1en- Care-
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