title: Australian deceased donor kidney allocation protocols: Transplant waiting and graft quality for children and adolescents.
abstract: DD kidney allocation protocols may influence timing of transplantation and graft quality for pediatric recipients. This study aimed to evaluate the effects of these protocols, including pediatric priority, on waiting time on dialysis, transplant type, donor age, and HLA matching according to state of transplant in Australia. De-identified information on patients <15 yr of age who commenced RRT in NSW, Qld, and Victoria from 2002 to 2011 was retrieved from the ANZDATA. Transplant type, donor age, and HLA mismatching were compared between states, with competing risk regression used to examine the time to transplant. There were significant differences in waiting time to DD transplantation between the three states. Children in NSW and Qld waited a median of 14 and 11 months vs. 21 months in Victoria. The ratio of LD to DD transplants was lower in NSW and Qld. Differences correlated with DD pediatric priority in NSW and Qld. DDs in NSW were older than in the other states. HLA matching did not differ. DD kidney allocation protocols with pediatric priority in Australian states were associated with shorter waiting times and increased DD proportion.
authors.affiliation: Nephrology, Monash Children's Hospital, Clayton, Vic., Australia.|Department of Paediatrics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia.|Australian and New Zealand Dialysis and Transplant Registry (ANZDATA), Royal Adelaide Hospital, Adelaide, SA, Australia.
authors.forename: Amelia K
authors.initials: AK
authors.lastname: Le Page
authors.affiliation: Nephrology, Monash Children's Hospital, Clayton, Vic., Australia.|Department of Paediatrics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia.|Australian and New Zealand Dialysis and Transplant Registry (ANZDATA), Royal Adelaide Hospital, Adelaide, SA, Australia.
authors.forename: Lilian M
authors.initials: LM
authors.lastname: Johnstone
authors.affiliation: Australian and New Zealand Dialysis and Transplant Registry (ANZDATA), Royal Adelaide Hospital, Adelaide, SA, Australia.|Nephrology, Sydney Children's Hospital, Randwick, NSW, Australia.|School of Women's and Childrens Health, UNSW Medicine, University of New South Wales, NSW, Australia.
authors.forename: Sean E
authors.initials: SE
authors.lastname: Kennedy
mesh_terms: D000293:Adolescent; D001315:Australia; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000592:standards*; D008297:Male; D018579:Patient Selection; D016016:Proportional Hazards Models; D011785:Quality Assurance, Health Care; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data; D009927:Tissue and Organ Procurement / Q000458:organization & administration / Q000592:standards* / Q000706:statistics & numerical data; D014850:Waiting Lists
keywords: allocation; children; kidney; transplantation; waiting time