title: Current organ allocation disadvantages kidney alone recipients over combined organ recipients.
abstract: BACKGROUND
  The United Network for Organ Sharing began including the Kidney Donor Profile Index (KDPI) March 26, 2012 and began a new allocation scheme December 1, 2014.
  
  
  METHODS
  Kidney donors from our organ procurement organization from March 2012 to December 2014 were reviewed. The KDPIs of all 919 kidney only transplants were compared with all 102 kidney/extrarenal transplants.
  
  
  RESULTS
  The average KDPI for kidney alone allografts was 47 (range 1 to 100) (standard deviation = 25.83) vs 27 for kidney/extrarenal kidneys (range 1 to 82) (standard deviation = 20.16) (P < .001, t test). Multivariate analysis including in- vs out-of-state recipient, donor body mass index, and donation after cardiac death vs brain-dead donor showed significantly lower KDPI for kidney/extrarenal transplants.
  
  
  CONCLUSIONS
  Kidney/extrarenal organs have decreased graft survival compared with kidneys transplanted alone. In this sample, 21% of lower KDPI kidneys were allocated as kidney/extrarenal organs. This disadvantages those waiting for a kidney alone. Attention to the outcomes of kidneys transplanted with extrarenal organs is needed.
authors.affiliation: Department of Surgery, St John Hospital & Medical Center, 22101 Moross Road, Detroit, MI 48236, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Martin
authors.affiliation: Gift of Life Michigan, Ann Arbor, MI, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Hagan
authors.affiliation: Department of Surgery, St John Hospital & Medical Center, 22101 Moross Road, Detroit, MI 48236, USA. Electronic address: darla.granger@stjohn.org.
authors.forename: Darla K
authors.initials: DK
authors.lastname: Granger
mesh_terms: D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D016378:Tissue Transplantation / Q000706:statistics & numerical data*; D009927:Tissue and Organ Procurement
keywords: Allocation; KDPI; Kidney transplant