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Take a kidney transplant now or wait for a better one? Hopkins researchers create 'decision' tool
Date:4/9/2013

s such as HIV and hepatitis C. But even when the tests come back negative, there is still a chance that some kidneys could be infected, more commonly with hepatitis C, because of donor risks such as intravenous drug abuse, prostitution, imprisonment and other criteria established by the U.S. Centers for Disease Control and Prevention. Although the risk of transmission of hepatitis C is low for transplanted kidneys, more than 10 percent of deceased donors in 2011 met the CDC criteria for infectious risk.

To develop the model, Segev and his colleagues pooled data from dozens of published papers and national databases of hundreds of thousands of patients. When information was missing, they sought out expert opinion to fill in the holes. They considered how long patients had been on a waiting list, whether they had undergone previous transplants, their age and whether they had diabetes, among other factors. Finally, they developed a complex statistical model and computer program to take all the factors into account and present it in a user-friendly manner.

Segev says there are more than 102,000 people on the kidney transplant waiting list in the United States, and thousands will die before they get an organ. The average waiting time for a kidney is three to five years, but in some regions of the United States, it can be as long as 10 years.

Some kidney transplant patients are healthy enough to safely reject a risky organ and wait for a better one. But that is not always the case.

Segev gives as one example a 45-year-old male who has been waiting two years for a new kidney, and thinks he has three more years to wait. Should he take an at-risk kidney, the Web-based tool says he would have a 78 percent chance of being alive in five years, even accounting for the possibility of an undetected infection such as hepatitis C. If he turns it down, his five-year survival is estimated to be 60 percent. It would make sense, according to Segev, f
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Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
Johns Hopkins Medicine
Source:Eurekalert

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