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Invited Critique
Dec 2012

Considerations Regarding Technology and Transplant Evaluations
Comment on “Evaluation of Potential Renal Transplant Recipients With Computed Tomography Angiography”

Arch Surg. 2012;147(12):1122. doi:10.1001/archsurg.2012.1499

Determining the most efficient, cost-effective evaluation of the potential kidney transplant recipient has become increasingly difficult. A variety of external forces have mandated that transplant centers reconsider their standard protocols. The disparity between the waiting list and organ availability is well known and continues to widen. This disparity, along with the increasing incidence of renal failure and aging of the population, means that potential recipients are older and have more intercurrent illnesses. The use of 1- and 3-year survival data as the measure of transplant center success has ensured that pretransplantation risk factors are more aggressively sought. Decreasing reimbursement and smaller margins have encouraged transplant programs to search for ways to improve efficiency of the evaluation process while simultaneously addressing stringent outcomes oversight.