Maximising Organ Donor Utility System-wide (MODUS): A study protocol for using linked health services data in multi-modal modelling of kidney transplant waitlist outcomes

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Abstract
Increasing deceased organ donation is a global priority constrained by concerns of inadvertent transmission of cancer or infectious disease from deceased organ donors. Up to 60% of potential donors referred for consideration for deceased organ donation in Australia do not proceed for biovigilance concerns. However, there are opportunities to increase acceptance. We aim to describe the impact of accepting or declining potential donors forgone for biovigilance concerns on patient and transplant outcomes. We will use data for all potential donors referred for consideration for deceased organ donation and data for patients ever waitlisted for kidney transplantation in New South Wales, Australia’s most populous state, 2010–2020. We will 1) describe the patient journey on the kidney transplant waitlist, including episodes of suspension and reactivation, time waiting and whether transplanted; 2) describe the characteristics of patients on the kidney transplant waitlist who decline a deceased donor organ offer and patient outcomes after their first decline; 3) determine potential gains made through increased donor acceptance and profile potential donors forgone for medical suitability; 4) use economic modelling to investigate the benefits and costs of increasing donor acceptance. Research findings will be presented at scientific conferences, published in the scientific media, and via collaborator networks.

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