Patients are willing to receive a worse-quality kidney sooner versus a better-quality kidney later in order to avoid additional waiting time for transplant, according to a study published in the Clinical Journal of the American Society of Nephrology. Sanjay Mehrota, PhD, and colleagues used a discretechoice experiment that presented a deceased donor kidney to 605 patients who were waiting for or had received a kidney transplant. The choice involved a tradeoff between accepting a kidney now or in the future; the options were designed to quantify the relative importance of kidney quality and waiting time. The average respondent would accept a kidney today with 6.5 years of expected graft survival to avoid an additional 2 years of waiting for a kidney with 11 years of expected graft survival. Three classes of patient preference were identified: class 1 was averse to extra waiting time but responsive to improvements in kidney quality; class 2 was less willing to accept a longer waiting time for improvements in kidney quality; and class 3 was willing to accept a longer waiting time even for a small improvement in kidney quality.
