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Yaghoubi M, Cressman S, Edwards L, Shechter S, Doyle-Waters MM, Keown P, Sapir-Pichhadze R, Bryan S. A Systematic Review of Kidney Transplantation Decision Modelling Studies. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2023; 21:39-51. [PMID: 35945483 DOI: 10.1007/s40258-022-00744-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/19/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Genome-based precision medicine strategies promise to minimize premature graft loss after renal transplantation, through precision approaches to immune compatibility matching between kidney donors and recipients. The potential adoption of this technology calls for important changes to clinical management processes and allocation policy. Such potential policy change decisions may be supported by decision models from health economics, comparative effectiveness research and operations management. OBJECTIVE We used a systematic approach to identify and extract information about models published in the kidney transplantation literature and provide an overview of the status of our collective model-based knowledge about the kidney transplant process. METHODS Database searches were conducted in MEDLINE, Embase, Web of Science and other sources, for reviews and primary studies. We reviewed all English-language papers that presented a model that could be a tool to support decision making in kidney transplantation. Data were extracted on the clinical context and modelling methods used. RESULTS A total of 144 studies were included, most of which focused on a single component of the transplantation process, such as immunosuppressive therapy or donor-recipient matching and organ allocation policies. Pre- and post-transplant processes have rarely been modelled together. CONCLUSION A whole-disease modelling approach is preferred to inform precision medicine policy, given its potential upstream implementation in the treatment pathway. This requires consideration of pre- and post-transplant natural history, risk factors for allograft dysfunction and failure, and other post-transplant outcomes. Our call is for greater collaboration across disciplines and whole-disease modelling approaches to more accurately simulate complex policy decisions about the integration of precision medicine tools in kidney transplantation.
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Affiliation(s)
- Mohsen Yaghoubi
- Department of Pharmacy Practice, Mercer University College of Pharmacy, Atlanta, USA
| | - Sonya Cressman
- Faculty of Health Sciences, Simon Fraser University, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Louisa Edwards
- School of Population and Public Health, University of British Columbia, Vancouver, V6T 1Z3, Canada
| | - Steven Shechter
- Sauder School of Business, University of British Columbia, Vancouver, Canada
| | - Mary M Doyle-Waters
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, Canada
| | - Paul Keown
- Department of Medicine, Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | | | - Stirling Bryan
- School of Population and Public Health, University of British Columbia, Vancouver, V6T 1Z3, Canada.
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Giwa S, Lewis JK, Alvarez L, Langer R, Roth AE, Church GM, Markmann JF, Sachs DH, Chandraker A, Wertheim JA, Rothblatt M, Boyden ES, Eidbo E, Lee WPA, Pomahac B, Brandacher G, Weinstock DM, Elliott G, Nelson D, Acker JP, Uygun K, Schmalz B, Weegman BP, Tocchio A, Fahy GM, Storey KB, Rubinsky B, Bischof J, Elliott JAW, Woodruff TK, Morris GJ, Demirci U, Brockbank KGM, Woods EJ, Ben RN, Baust JG, Gao D, Fuller B, Rabin Y, Kravitz DC, Taylor MJ, Toner M. The promise of organ and tissue preservation to transform medicine. Nat Biotechnol 2017; 35:530-542. [PMID: 28591112 PMCID: PMC5724041 DOI: 10.1038/nbt.3889] [Citation(s) in RCA: 312] [Impact Index Per Article: 44.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 04/28/2017] [Indexed: 02/06/2023]
Abstract
The ability to replace organs and tissues on demand could save or improve millions of lives each year globally and create public health benefits on par with curing cancer. Unmet needs for organ and tissue preservation place enormous logistical limitations on transplantation, regenerative medicine, drug discovery, and a variety of rapidly advancing areas spanning biomedicine. A growing coalition of researchers, clinicians, advocacy organizations, academic institutions, and other stakeholders has assembled to address the unmet need for preservation advances, outlining remaining challenges and identifying areas of underinvestment and untapped opportunities. Meanwhile, recent discoveries provide proofs of principle for breakthroughs in a family of research areas surrounding biopreservation. These developments indicate that a new paradigm, integrating multiple existing preservation approaches and new technologies that have flourished in the past 10 years, could transform preservation research. Capitalizing on these opportunities will require engagement across many research areas and stakeholder groups. A coordinated effort is needed to expedite preservation advances that can transform several areas of medicine and medical science.
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Affiliation(s)
- Sebastian Giwa
- Organ Preservation Alliance, NASA Research Park, Moffett Field, California, USA
- Sylvatica Biotech, Inc., Charleston, South Carolina, USA
- Ossium Health, San Francisco, California, USA
| | - Jedediah K Lewis
- Organ Preservation Alliance, NASA Research Park, Moffett Field, California, USA
| | - Luis Alvarez
- Regenerative Biology Research Group, Cancer and Developmental Biology Laboratory, National Cancer Institute, Bethesda, Maryland, USA
- Walter Reed National Military Medical Center, Bethesda, Maryland, USA
- Department of Chemistry and Life Science, United States Military Academy, West Point, New York, USA
| | - Robert Langer
- Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Alvin E Roth
- Department of Economics, Stanford University, Stanford, California, USA
| | - George M Church
- Department of Genetics, Harvard Medical School, Boston, Massachusetts, USA
| | - James F Markmann
- Division of Transplant Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - David H Sachs
- Columbia Center for Translational Immunology, Columbia University Medical Center, New York, New York, USA
| | - Anil Chandraker
- American Society of Transplantation, Mt. Laurel, New Jersey, USA
- Transplantation Research Center, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jason A Wertheim
- American Society of Transplant Surgeons, Arlington Virginia, USA
- Comprehensive Transplant Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Edward S Boyden
- MIT Media Lab and McGovern Institute, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Elling Eidbo
- Association of Organ Procurement Organizations, Vienna, Virginia, USA
| | - W P Andrew Lee
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Bohdan Pomahac
- Department of Surgery, Division of Plastic Surgery, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Gerald Brandacher
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David M Weinstock
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Gloria Elliott
- Department of Mechanical Engineering and Engineering Science, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - David Nelson
- Department of Transplant Medicine, Nazih Zuhdi Transplant Institute, Integris Baptist Medical Center, Oklahoma City, Oklahoma, USA
| | - Jason P Acker
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
- Society for Cryobiology, Baltimore, Maryland, USA
| | - Korkut Uygun
- Department of Surgery, Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Boris Schmalz
- Organ Preservation Alliance, NASA Research Park, Moffett Field, California, USA
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Brad P Weegman
- Organ Preservation Alliance, NASA Research Park, Moffett Field, California, USA
- Sylvatica Biotech, Inc., Charleston, South Carolina, USA
| | - Alessandro Tocchio
- Organ Preservation Alliance, NASA Research Park, Moffett Field, California, USA
- Department of Radiology, Stanford School of Medicine, Stanford, California, USA
| | - Greg M Fahy
- 21st Century Medicine, Fontana, California, USA
| | - Kenneth B Storey
- Institute of Biochemistry, Carleton University, Ottawa, Ontario, Canada
| | - Boris Rubinsky
- Department of Mechanical Engineering, University of California Berkeley, Berkeley, California, USA
| | - John Bischof
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, Minnesota, USA
| | - Janet A W Elliott
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
- Department of Chemical and Materials Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Teresa K Woodruff
- Division of Obstetrics and Gynecology-Reproductive Science in Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Utkan Demirci
- Department of Radiology, Stanford School of Medicine, Stanford, California, USA
- Department of Electrical Engineering (by courtesy), Stanford, California, USA
| | | | - Erik J Woods
- Ossium Health, San Francisco, California, USA
- Society for Cryobiology, Baltimore, Maryland, USA
- Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Robert N Ben
- Department of Chemistry and Biomolecular Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - John G Baust
- Department of Biological Sciences, Binghamton University, State University of New York, Binghamton, New York, USA
| | - Dayong Gao
- Society for Cryobiology, Baltimore, Maryland, USA
- Department of Mechanical Engineering, University of Washington, Seattle, Washington, USA
| | - Barry Fuller
- Division of Surgery &Interventional Science, University College Medical School, Royal Free Hospital Campus, London, UK
| | - Yoed Rabin
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | | | - Michael J Taylor
- Sylvatica Biotech, Inc., Charleston, South Carolina, USA
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
- Department of Surgery, University of Arizona, Tucson, Arizona, USA
| | - Mehmet Toner
- Department of Surgery, Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Stoler A, Kessler JB, Ashkenazi T, Roth AE, Lavee J. Incentivizing Authorization for Deceased Organ Donation With Organ Allocation Priority: The First 5 Years. Am J Transplant 2016; 16:2639-45. [PMID: 27013023 DOI: 10.1111/ajt.13802] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 02/25/2016] [Accepted: 03/13/2016] [Indexed: 01/25/2023]
Abstract
The allocation system of donor organs for transplantation may affect their scarcity. In 2008, Israel's Parliament passed the Organ Transplantation Law, which grants priority on waiting lists for transplants to candidates who are first-degree relatives of deceased organ donors or who previously registered as organ donors themselves. Several public campaigns have advertised the existence of the law since November 2010. We evaluated the effect of the law using all deceased donation requests made in Israel during the period 1998-2015. We use logistic regression to compare the authorization rates of the donors' next of kin in the periods before (1998-2010) and after (2011-2015) the public was made aware of the law. The authorization rate for donation in the period after awareness was substantially higher (55.1% vs. 45.0%, odds ratio [OR] 1.43, p = 0.0003) and reached an all-time high rate of 60.2% in 2015. This increase was mainly due to an increase in the authorization rate of next of kin of unregistered donors (51.1% vs. 42.2%). We also found that the likelihood of next-of-kin authorization for donation was approximately twice as high when the deceased relative was a registered donor rather than unregistered (89.4% vs. 44.6%, OR 14.27, p < 0.0001). We concluded that the priority law is associated with an increased authorization rate for organ donation.
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Affiliation(s)
- A Stoler
- Department of Economics, DePaul University, Chicago, IL.,Coherent Economics, Highland Park, IL
| | - J B Kessler
- Department of Business Economics and Public Policy, The Wharton School at the University of Pennsylvania, Philadelphia, PA
| | - T Ashkenazi
- Israel National Transplant Center, State Ministry of Health, Tel-Aviv, Israel
| | - A E Roth
- Department of Economics, Stanford University, Stanford, CA
| | - J Lavee
- Heart Transplantation Unit, Department of Cardiac Surgery, Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
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