Priority 24 from the Kidney Transplant PSP

UNCERTAINTY: Is there a reliable way for us to assess the suitability of individual organs for transplantation, and to predict outcomes?
Overall ranking Priority questions agreed on but not put in ranked order
JLA question ID 0037/24
Explanatory note Not available for this PSP
Evidence

Existing Systematic Reviews: Bhangoo, R S., Hall, I E., Reese, P P., Parikh, C R. Deceased-donor kidney perfusate and urine biomarkers for kidney allograft outcomes: a systematic review. Nephrology Dialysis Transplantation. 2012;27(8):3305-14 ~
Wang CJ, Wetmore JB, Crary GS and Kasiske BL.  The donor kidney biopsy and its implications in predicting graft outcomes: A systematic review.  Am J Transplant 2015, epub ahead of print
Existing Randomised Controlled Trials: Nagelschmidt, M., Minor, T., Gallinat, A., Moers, C., Jochmans, I., Pirenne, J., Ploeg, R. J., Paul, A., Treckmann, J. Lipid peroxidation products in machine perfusion of older donor kidneys. Journal of Surgical Research. 2013;180(2):337-342 ~
Moers, C., Varnav, O. C., van Heurn, E., Jochmans, I., Kirste, G. R., Rahmel, A., Leuvenink, H. G., Squifflet, J. P., Paul, A., Pirenne, J., et al. The Value of Machine Perfusion Perfusate Biomarkers for Predicting Kidney Transplant Outcome. Transplantation. 2010;(966-973)
Health Research Classification System category Renal and Urogenital
Extra information provided by this PSP
Original uncertainty examples

How can marginal organs be better assessed for function before transplantation? How can we be more certain about the quality of donor organs from deceased donors? How do we improve outcomes for organs from donation after cardiac death? In deceased donor transplantation, how can we better predict which organs are suitable for transplantation? Can we identify biomarkers for good/bad organ function? why do all the renal centers appear to have different acceptance criteria regarding the donor organ? If I do not accept the kidney on offer to me how long will I have to wait until I receive another offer? Will I live longer if I accept this kidney than if I stay on dialysis? Is this kidney a good kidney for me?

 
Comparison Service delivery
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Clinicians x 9
Outcomes to be measured Transplant rates, discard rates
PSP information
PSP unique ID 0037
PSP name Kidney Transplant
Total number of uncertainties identified by this PSP. 90  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 3 February 2016