The findings, which will appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN), suggest that broader geographic sharing of kidneys for children should be considered.
Kidneys are distributed to transplant recipients first locally within nearby geographic areas, then regionally and nationally based on a pre-defined allocation system. Although children receive priority for kidneys from deceased donors who are less than 35 years of age, there are several categories of candidates that supersede children on the waiting list.
Sandra Amaral, MD, MHS, assistant professor of Pediatrics and Epidemiology at Penn and CHOP and Peter Reese, MD , MSCE, assistant professor of Medicine and Epidemiology at Penn, led a team that examined whether local organ supply influences waiting times for children. They also sought to examine whether the allocation of organs to other higher priority candidates impacts waiting times for children on the deceased donor kidney waiting list.
The researchers found that there is substantial and very concerning geographic variation in deceased donor kidney waiting times for children across the United States, with median waiting time ranging from as little as two weeks to as long as three years. In some cases, donor service areas with very long pediatric waiting times are right next to donor service areas with very short pediatric waiting times.
The investigators did not find that differences in waiting times were driven by the distribution of organs to other higher priority candidates. Waiting times for children were, however, affected by the local supply of high quality organs.
Dr. Amaral’s research is supported by a career development award from the NIDDK (K23 DK083529).
Additional study authors from Penn include Hojun Hwang, Vishnu Potluri, MBBS, MPH, Peter L. Abt, MD, and Justine Shults, PhD.
For more information, please see the JASN news release JASN news release.
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