Changes in pediatric renal transplantation after implementation of the revised deceased donor kidney allocation policy

S. Agarwal, N. Oak, J. Siddique, R. C. Harland, E. D. Abbo

Research output: Contribution to journalArticle

43 Scopus citations


In October 2005, the United Network for Organ Sharing (UNOS) implemented a revised allocation policy requiring that renal allografts from young deceased donors (DDs) (<35 years old) be offered preferentially to pediatric patients (<18 years old). In this study, we compare the pre- and postpolicy quarterly pediatric transplant statistics from 2000 to 2008. The mean number of pediatric renal transplants with young DDs increased after policy implementation from 62.8 to 133 per quarter (p < 0.001), reflecting a change in the proportion of all transplants from young DDs during the study period from 0.33 to 0.63 (p < 0.001). The mean number of pediatric renal transplants from old DDs (≥35 years old) decreased from 22.4 to 2.6 per quarter (p < 0.001). The proportion of all pediatric renal transplants from living donors decreased from 0.55 to 0.35 (p < 0.001). The proportion from young DDs with five or six mismatched human leukocyte antigen (HLA) loci increased from 0.16 to 0.36 (p < 0.001) while those with 0 to 4 HLA mismatches increased from 0.18 to 0.27 (p < 0.001). Revision of UNOS policy has increased the number of pediatric renal transplants with allografts from young DDs, while increasing HLA-mismatched allografts and decreasing the number from living donors.

Original languageEnglish (US)
Pages (from-to)1237-1242
Number of pages6
JournalAmerican Journal of Transplantation
Issue number5
Publication statusPublished - May 1 2009
Externally publishedYes



  • Decision analysis
  • Donation rates
  • Donor age
  • Health policy
  • Kidney allocation
  • Kidney transplantation
  • Organ donation
  • Organ Procurement and Transplantation Network
  • Organ procurement systems
  • Pediatric kidney transplantation
  • Policy analysis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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