PMID- 16827872
OWN - NLM
STAT- MEDLINE
DCOM- 20061207
LR  - 20230124
IS  - 1600-6135 (Print)
IS  - 1600-6135 (Linking)
VI  - 6
IP  - 7
DP  - 2006 Jul
TI  - The expanded criteria donor policy: an evaluation of program objectives and 
      indirect ramifications.
PG  - 1689-95
AB  - The expanded criteria donor (ECD) policy was formalized in 2002, which defined 
      higher-risk deceased donor kidneys recovered for transplantation. There has not 
      been a comprehensive examination of the impact of policy on the allocation of ECD 
      kidneys, waiting times for transplant, center listing patterns or human leukocyte 
      antigen (HLA) matching. We examined transplant candidates from 1998 to 2004 
      utilizing a national database. We constructed models to assess alterations in 
      recipient characteristics of ECD kidneys and trends in waiting time and cold 
      ischemia time (CIT) associated with policy. We also evaluated the impact of the 
      proportion of center candidate listings for ECD kidneys on waiting times. Elderly 
      recipients were more likely to receive ECDs following policy (odds ratio = 1.36, 
      p < 0.01). There was no association of decreased CIT or pretransplant dialysis 
      time while increasing HLA mismatching with policy inception. Over one quarter of 
      centers listed < 20% of candidates for ECDs, while an additional quarter of 
      centers listed > 90%. Only centers with selective listing for ECDs offered 
      reduced waiting times to ECD recipients. The ECD policy demonstrates potential to 
      achieve certain ascribed goals; however, the full impact of the program, reaching 
      all transplant candidates, may only be achieved once ECD listing patterns are 
      recommended and adopted accordingly.
FAU - Schold, J D
AU  - Schold JD
AD  - Department of Medicine, University of Florida, Gainesville, Florida, USA. 
      scholjd@medicine.ufl.edu
FAU - Howard, R J
AU  - Howard RJ
FAU - Scicchitano, M J
AU  - Scicchitano MJ
FAU - Meier-Kriesche, H-U
AU  - Meier-Kriesche HU
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Transplant
JT  - American journal of transplantation : official journal of the American Society of 
      Transplantation and the American Society of Transplant Surgeons
JID - 100968638
RN  - 0 (Antigens)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Distribution
MH  - Aged
MH  - Antigens/immunology
MH  - Female
MH  - Humans
MH  - Leukocytes/immunology
MH  - Male
MH  - Middle Aged
MH  - *Program Evaluation
MH  - Tissue Donors/*classification/*legislation & jurisprudence
EDAT- 2006/07/11 09:00
MHDA- 2006/12/09 09:00
CRDT- 2006/07/11 09:00
PHST- 2006/07/11 09:00 [pubmed]
PHST- 2006/12/09 09:00 [medline]
PHST- 2006/07/11 09:00 [entrez]
AID - S1600-6135(22)03931-4 [pii]
AID - 10.1111/j.1600-6143.2006.01390.x [doi]
PST - ppublish
SO  - Am J Transplant. 2006 Jul;6(7):1689-95. doi: 10.1111/j.1600-6143.2006.01390.x.