{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T14:40:37Z","timestamp":1777992037514,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T00:00:00Z","timestamp":1568073600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Kidney Foundation","award":["Young Investigator Grant"],"award-info":[{"award-number":["Young Investigator Grant"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Prog Transpl"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>The Kidney Allocation System in the United States prioritizes candidates with Estimated Post-Transplant Survival (EPTS) \u226420% to receive deceased donor kidneys with Kidney Donor Profile Index (KDPI) \u226420%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research Question:<\/jats:title>\n                    <jats:p>We compared access to KDPI \u2264 20% kidneys for EPTS \u2264 20% candidates across the United States to determine whether geographic disparities in access to these low KDPI kidneys exist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>We identified all incident adult deceased donor kidney candidates wait-listed January 1, 2015, to March 31, 2018, using United Network for Organ Sharing data. We calculated the proportion of candidates transplanted, final EPTS, and KDPI of transplanted kidneys for candidates listed with EPTS \u2264 20% versus &gt;20%. We compared the odds of receiving a KDPI \u2264 20% deceased donor kidney for EPTS \u2264 20% candidates across regions using logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 121 069 deceased donor kidney candidates, 28.5% had listing EPTS \u2264 20%. Of these, 16.1% received deceased donor kidney transplants (candidates listed EPTS &gt; 20%: 17.1% transplanted) and 12.3% lost EPTS \u2264 20% status. Only 49.4% of transplanted EPTS \u2264 20% candidates received a KDPI \u2264 20% kidney, and 48.3% of KDPI \u2264 20% kidneys went to recipients with EPTS &gt; 20% at the time of transplantation. Odds of receiving a KDPI \u2264 20% kidney were highest in region 6 and lowest in region 9 (odds ratio 0.19 [0.13 to 0.28]). The ratio of KDPI \u2264 20% donors per EPTS \u2264 20% candidate and likelihood of KDPI \u2264 20% transplantation were strongly correlated ( r\n                      <jats:sup>2<\/jats:sup>\n                      = 0.84).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>Marked geographic variation in the likelihood of receiving a KDPI \u2264 20% deceased donor kidney among transplanted EPTS \u2264 20% candidates exists and is related to differences in organ availability within allocation borders. Policy changes to improve organ sharing are needed to improve equity in access to low KDPI kidneys.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1526924819874699","type":"journal-article","created":{"date-parts":[[2019,9,11]],"date-time":"2019-09-11T00:18:56Z","timestamp":1568161136000},"page":"354-360","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Regional Disparities in Transplantation With Deceased Donor Kidneys With Kidney Donor Profile Index Less Than 20% Among Candidates With Top 20% Estimated Post Transplant Survival"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1823-0117","authenticated-orcid":false,"given":"S. Ali","family":"Husain","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, NY, USA"},{"name":"The Columbia University Renal Epidemiology (CURE) Group, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristen L.","family":"King","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, NY, USA"},{"name":"The Columbia University Renal Epidemiology (CURE) Group, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geoffrey K.","family":"Dube","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Demetra","family":"Tsapepas","sequence":"additional","affiliation":[{"name":"NewYork\u2013Presbyterian Hospital, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lloyd E.","family":"Ratner","sequence":"additional","affiliation":[{"name":"Department of Surgery, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sumit","family":"Mohan","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Columbia University Medical Center, New York, NY, USA"},{"name":"The Columbia University Renal Epidemiology (CURE) Group, New York, NY, USA"},{"name":"Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,9,10]]},"reference":[{"key":"bibr1-1526924819874699","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.05350513"},{"key":"bibr2-1526924819874699","doi-asserted-by":"publisher","DOI":"10.1097\/01.tp.0000438623.89310.dc"},{"key":"bibr3-1526924819874699","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14622"},{"key":"bibr4-1526924819874699","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2010.03043.x"},{"key":"bibr5-1526924819874699","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2011.03789.x"},{"key":"bibr6-1526924819874699","doi-asserted-by":"publisher","DOI":"10.1001\/jama.294.21.2726"},{"key":"bibr7-1526924819874699","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12830"},{"key":"bibr8-1526924819874699","unstructured":"Organ Procurement and Transplantation Network. Policies. https:\/\/optn.transplant.hrsa.gov\/media\/1200\/optn_policies.pdf#nameddest=Policy_08. Published 2019. Accessed July 31, 2019."},{"key":"bibr9-1526924819874699","unstructured":"Organ Procurement and Transplantation Network. A guide to calculating and interpreting the Estimated Post-Transplant Survival (EPTS) score used in the Kidney Allocation System (KAS). https:\/\/optn.transplant.hrsa.gov\/media\/1511\/guide_to_calculating_interpreting_epts.pdf. Published 2018. Accessed July 31, 2019."},{"key":"bibr10-1526924819874699","unstructured":"Organ Procurement and Transplantation Network. Guide to calculating and interpreting the Kidney Donor Profile Index (KDPI). https:\/\/optn.transplant.hrsa.gov\/media\/1512\/guide_to_calculating_interpreting_kdpi.pdf. Published 2018. Accessed December 4, 2018."},{"key":"bibr11-1526924819874699","unstructured":"Organ Procurement and Transplantation Network. Policy 8: Allocation of Kidneys. https:\/\/optn.transplant.hrsa.gov\/media\/1200\/optn_policies.pdf. Published 2019. Accessed July 31, 2019."},{"key":"bibr12-1526924819874699","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199912023412303"},{"key":"bibr13-1526924819874699","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V115917"},{"key":"bibr14-1526924819874699","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2004121092"},{"issue":"63","key":"bibr15-1526924819874699","first-page":"16296","volume":"63","year":"1998","journal-title":"Fed Regist"},{"key":"bibr16-1526924819874699","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14922"},{"key":"bibr17-1526924819874699","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13362"},{"key":"bibr18-1526924819874699","unstructured":"Centers for Disease Control and Prevention. Mortality Tables. https:\/\/www.cdc.gov\/nchs\/data\/dvs\/mortfinal2007_worktable23r.pdf. Accessed July, 31 2019."},{"key":"bibr19-1526924819874699","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15115"},{"key":"bibr20-1526924819874699","doi-asserted-by":"publisher","DOI":"10.1007\/s40472-018-0175-z"},{"key":"bibr21-1526924819874699","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12557"},{"key":"bibr22-1526924819874699","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14132"},{"key":"bibr23-1526924819874699","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13770"},{"key":"bibr24-1526924819874699","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14379"}],"container-title":["Progress in Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1526924819874699","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1526924819874699","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1526924819874699","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T05:40:15Z","timestamp":1777700415000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1526924819874699"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,10]]},"references-count":24,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1177\/1526924819874699"],"URL":"https:\/\/doi.org\/10.1177\/1526924819874699","relation":{},"ISSN":["1526-9248","2164-6708"],"issn-type":[{"value":"1526-9248","type":"print"},{"value":"2164-6708","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,10]]}}}