Many kidney transplant candidates die while on the waiting list for transplantation. At the time of waiting list placement, candidates may consent to receive donor kidneys with lower expected survival (eg, kidney donor profile index [KDPI] >85%). It is believed that consent may increase the likelihood and timeliness of donor offers for transplantation. However, the impact of consent on access to transplantation is unclear.
Jesse D. Schold and others evaluated the characteristics of candidates consenting to high-KDPI donor kidneys and their likelihood of receiving a deceased donor transplant (DDTX) based on consent over time. The researchers utilized data from the Scientific Registry of Transplant Recipients between 2015 and 2022 (n=213,364) and assessed the likelihood of consent using multivariable logistic models and time to DDTX with cumulative incidence plots accounting for competing risks and multivariable Cox models.
High-KDPI consent was 41% and was higher among individuals who were Black or Hispanic, older, had higher BMI, had diabetes, had vascular disease, and had 12 to 48 months prelisting dialysis time, with significant center-level variation. High-KDPI consent was associated with higher rates of DDTX (adjusted HR, 1.15; 95% CI, 1.13-1.17), but there was no difference in the likelihood of DDTX from donors with KDPI <85%. The effect of high-KDPI consent on higher rates of DDTX was higher among candidates ages >60 years and diabetic candidates, and it varied based on center characteristics.
In sum, the study authors noted that there is significant variation of consent for high-KDPI donor kidneys and a higher likelihood of transplantation associated with consent.
© 2025 Mashup Media, LLC, a Formedics Property. All Rights Reserved.