TY - JOUR
T1 - A Roadmap for Innovation to Advance Transplant Access and Outcomes
T2 - A Position Statement From the National Kidney Foundation
AU - Lentine, Krista L.
AU - Pastan, Stephen
AU - Mohan, Sumit
AU - Reese, Peter P.
AU - Leichtman, Alan
AU - Delmonico, Francis L.
AU - Danovitch, Gabriel M.
AU - Larsen, Christian P.
AU - Harshman, Lyndsay
AU - Wiseman, Alexander
AU - Kramer, Holly J.
AU - Vassalotti, Joseph
AU - Joseph, Jessica
AU - Longino, Kevin
AU - Cooper, Matthew
AU - Axelrod, David A.
N1 - Funding Information:
The Transplant Research Roundtable was supported by the National Kidney Foundation . No additional support was obtained.
Funding Information:
Krista L. Lentine, MD, PhD, Stephen Pastan, MD, Sumit Mohan, MD, MPH, Peter P. Reese, MD, MSCE, Alan Leichtman, MD, Francis L. Delmonico, MD, Gabriel M. Danovitch, MD, Christian P. Larsen, MD, PhD, Lyndsay Harshman, MD, MS, Alexander Wiseman, MD, Holly J. Kramer, MD, MPH, Joseph Vassalotti, MD, Jessica Joseph, MBA, Kevin Longino, MBA, Matthew Cooper, MD, and David A. Axelrod, MD, MBA. The Transplant Research Roundtable was supported by the National Kidney Foundation. No additional support was obtained. Dr Lentine reports receiving consulting fees from CareDx, speaker honoraria from Sanofi, and research support from the National Institutes of Health (NIH; U01DK116042, R01DK120551, and R01DK125018) and the Mid-America Transplant Foundation; she is a senior scientist of the Scientific Registry of Transplant Recipients. Dr Pastan reports membership on the Board of Directors for the NKF and the Forum of End-Stage Renal Disease (ESRD) Networks, and is a Chairman of the local Board of IPRO/ESRD Network 6. Dr Mohan reports grant support from NIH (R01DK126739, U01DK114893, and R01MD014161) and Angion Biomedica and personal fees from Kidney International Reports and Angio Biomedica. Dr Reese reports having received research support to the University of Pennsylvania from Merck, AbbVie, and Gilead to investigate transplantation of hepatitis C virus?infected organs into uninfected recipients followed by antiviral treatment; serves as AJKD Associate Editor; and is an unpaid consultant to eGenesis, a company developing xenotransplantation technology. Dr Leichtman is a consultant to Arbor Research Collaborative for Health, a member of the governing board of Gift of Life Michigan, and a partner in Compass Integrated Care. Dr Delmonico reports receiving salary from the New England Donor Services in Massachusetts General Hospital. Dr Wiseman reports receiving consultant fees for Veloxis, CareDx, and Natera, and has received speaking fees for Veloxis. Dr Kramer reports membership on the NKF Board of Directors, serves as a consultant for Bayer Pharmaceuticals, and serves as AJKD Engagement Editor. Dr Vassalotti reports having served on a CKD advisory board for Renalytix AI, PLC. Ms Joseph and Mr Longino are employed by the NKF. Dr Cooper reports membership on the NKF Board of Directors. Dr Axelrod reports receiving consultation fees from CareDx and Talaris and serves on the advisory board for Veloxis. The remaining authors declare that they have no relevant financial interests. The authors thank Debra Taylor, MPH, for assistance with manuscript preparation. The authors also thank Saint Louis University biostatisticians Huiling Xiao, MS, and Ruixin Li, MS, for assistance with SRTR data analysis and figure preparation. Data reported here have been supplied by the Hennepin Healthcare Research Institute (HHRI) as the contractor for the Scientific Registry of Transplant Recipients (SRTR). The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy of or interpretation by the SRTR or the US Government. Received April 17, 2021, following review and approval by the NKF Scientific Advisory Board (membership listed at https://www.kidney.org/about/sab) and the NKF Executive Committee (listed at https://www.kidney.org/about/board). Accepted May 1, 2021, after editorial review by a Deputy Editor.
Publisher Copyright:
© 2021 National Kidney Foundation, Inc.
PY - 2021/9
Y1 - 2021/9
N2 - Over the past 65 years, kidney transplantation has evolved into the optimal treatment for patients with kidney failure, dramatically reducing suffering through improved survival and quality of life. However, access to transplant is still limited by organ supply, opportunities for transplant are inequitably distributed, and lifelong transplant survival remains elusive. To address these persistent needs, the National Kidney Foundation convened an expert panel to define an agenda for future research. The key priorities identified by the panel center on the needs to develop and evaluate strategies to expand living donation, improve waitlist management and transplant readiness, maximize use of available deceased donor organs, and extend allograft longevity. Strategies targeting the critical goal of decreasing organ discard that warrant research investment include educating patients and clinicians about potential benefits of accepting nonstandard organs, use of novel organ assessment technologies and real-time decision support, and approaches to preserve and resuscitate allografts before implantation. The development of personalized strategies to reduce the burden of lifelong immunosuppression and support “one transplant for life” was also identified as a vital priority. The panel noted the specific goal of improving transplant access and graft survival for children with kidney failure. This ambitious agenda will focus research investment to promote greater equity and efficiency in access to transplantation, and help sustain long-term benefits of the gift of life for more patients in need.
AB - Over the past 65 years, kidney transplantation has evolved into the optimal treatment for patients with kidney failure, dramatically reducing suffering through improved survival and quality of life. However, access to transplant is still limited by organ supply, opportunities for transplant are inequitably distributed, and lifelong transplant survival remains elusive. To address these persistent needs, the National Kidney Foundation convened an expert panel to define an agenda for future research. The key priorities identified by the panel center on the needs to develop and evaluate strategies to expand living donation, improve waitlist management and transplant readiness, maximize use of available deceased donor organs, and extend allograft longevity. Strategies targeting the critical goal of decreasing organ discard that warrant research investment include educating patients and clinicians about potential benefits of accepting nonstandard organs, use of novel organ assessment technologies and real-time decision support, and approaches to preserve and resuscitate allografts before implantation. The development of personalized strategies to reduce the burden of lifelong immunosuppression and support “one transplant for life” was also identified as a vital priority. The panel noted the specific goal of improving transplant access and graft survival for children with kidney failure. This ambitious agenda will focus research investment to promote greater equity and efficiency in access to transplantation, and help sustain long-term benefits of the gift of life for more patients in need.
KW - Deceased donor organ transplantation
KW - disparities
KW - end-stage kidney disease (ESKD)
KW - graft survival
KW - immunosuppression
KW - kidney transplantation
KW - living donation
KW - organ donation
KW - patient survival
KW - research priorities
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U2 - 10.1053/j.ajkd.2021.05.007
DO - 10.1053/j.ajkd.2021.05.007
M3 - Comment/debate
C2 - 34330526
AN - SCOPUS:85112514491
SN - 0272-6386
VL - 78
SP - 319
EP - 332
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 3
ER -