Order of Deceased Donor and Living Donor Kidney Transplantation in Pediatric Recipients

Plot Image

Enter Patient/Donor Characteristics

patient age: 11, patient gender: F, patient ethnicity: caucasian, patient months on dialysis: 0, patient previous transplant: no, patient etiology of renal disease: other, patient ABO: A, patient PRA: 0-5%, donor age: 33, donor gender: F, donor ethnicity: caucasian, HLA mismatches: 0, donor history of smoking: no, estimated regional waiting time to deceased donor transplant (as child): 6 months, (as adult): 36 months.

72.4% of 1000 simulated patients with these characteristics survive to 20 years after their decision to accept a primary living donor transplant.
65.5% of 1000 simulated patients with these characteristics survive to 20 years after their decision to wait for a primary deceased donor transplant.

This model is intended to compare, for a given pediatric patient with only one living donor available, long-term patient survival after 1) living donor kidney transplantation followed if necessary by deceased donor retransplantation versus 2) deceased donor kidney transplantation followed if necessary by living donor (if donor is still able to donate) or deceased donor (if not) retransplantation. The model accounts for waitlist, graft, and patient survival, sensitization, the increased risk of graft failure seen during late adolescence, differential deceased donor waiting times based upon pediatric-priority allocation policies, and aging or disease development leading to ineligibility of the living donor over time.

Based on research done by Van Arendonk KJ, Chow EK, James NT, Orandi BJ, Smith JM, Colombani PM, and Segev DL. Order of Deceased Donor and Living Donor Kidney Transplantation in Pediatric Recipients: A Markov Decision Process Model to Aid in Clinical Decision-Making.

Web Application developed by by Eric Chow, Xun Luo, and Mary Grace Bowring.

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