Calculating life years from transplant (LYFT): Methods for kidney and kidney-pancreas candidates

R. A. Wolfe, K. P. McCullough, D. E. Schaubel, J. D. Kalbfleisch, S. Murray, M. D. Stegall, A. B. Leichtman

Research output: Contribution to journalArticle

130 Scopus citations

Abstract

The Organ Procurement and Transplantation Network (OPTN) Kidney Committee is considering a proposal for a new deceased donor kidney allocation system. Among the components under consideration is a strategy to rank candidates in part by the estimated incremental years of life that are expected to be achieved with a transplant from a specific available deceased donor, computed as the difference in expected median lifespan with that transplant compared with remaining on dialysis. This concept has been termed life years from transplant or LYFT. Median lifespans could be calculated, based on objective medical criteria, for each candidate when a deceased donor kidney becomes available, based on Cox regression models using current candidate and donor medical information. The distribution of the calculated LYFT scores for an average nonexpanded criteria donor kidney is similar across candidate sex, race/ethnicity, insurance status and, with the exception of diabetes, diagnosis. LYFT scores tend to be higher for younger candidates and lower for diabetics receiving a kidney-alone rather than a simultaneous kidney-pancreas transplant. Prioritizing candidates with higher LYFT scores for each available kidney could substantially increase total years of life among both transplant candidates and recipients. LYFT is also a powerful metric for assessing trends in allocation outcomes and for comparing alternative allocation systems.

Original languageEnglish (US)
Pages (from-to)997-1011
Number of pages15
JournalAmerican Journal of Transplantation
Volume8
Issue number4 PART 2
DOIs
StatePublished - Apr 1 2008

Keywords

  • Cox regression
  • Deceased donor kidneys
  • Diabetes mellitus
  • Kidney allocation
  • Kidney transplant
  • Life expectancy
  • OPTN
  • SRTR
  • Simultaneous kidney-pancreas transplant
  • Survival
  • Waiting list
  • Waiting list mortality

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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    Wolfe, R. A., McCullough, K. P., Schaubel, D. E., Kalbfleisch, J. D., Murray, S., Stegall, M. D., & Leichtman, A. B. (2008). Calculating life years from transplant (LYFT): Methods for kidney and kidney-pancreas candidates. American Journal of Transplantation, 8(4 PART 2), 997-1011. https://doi.org/10.1111/j.1600-6143.2008.02177.x