# Using Decision Making Science to Optimize Deceased Donor Kidney Allocation

> **NIH NIH K23** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2022 · $165,456

## Abstract

PROJECT SUMMARY/ABSTRACT
Although kidney transplantation provides better survival, quality of life, and long-term cost compared to
maintenance dialysis, the majority of patients with end-stage kidney disease in the United States will never
receive a transplant due to a severe shortage of donated kidneys. In response to this shortage, there has been
an increasing emphasis on expanding the use of less-than-ideal deceased donor kidneys, which still provide
survival and quality of life benefits over extended waiting time for a higher quality kidney. Despite efforts to
increase the aggressiveness of organ recovery and utilization, thousands of likely transplantable kidneys are not
recovered or discarded after recovery each year, primarily due to quality concerns. We and others have shown
that clinicians’ subjective assessments of organ quality are often too conservative, and that cognitive heuristics
impact perception or organ quality and likelihood of organ utilization. A key target for improving perceptions of
organ quality is therefore to use decision science to improve the presentation of information during organ offers.
The goal of the proposed project is to understand how surgeons prioritize and consume information during organ
offer decisions, then use a mechanisms-based approach to target cognitive heuristics that favor inappropriate
organ offer refusal. We will begin with improving the presentation of the results of procurement biopsies. Despite
reliance on findings from these biopsies— which are the most common reason for deceased donor kidney
discard— their independent prognostic capability is limited as they are currently performed. We hypothesize that
our approach will enable standardization of procurement biopsy presentation in a manner that reduces
deleterious impacts on organ offer acceptance.
To complete the proposed project and acquire the skills needed for development into an independent investigator
in the field of kidney transplantation, Dr. Husain will work closely with a multidisciplinary team of mentors and
advisors, led by Dr. Sumit Mohan, to develop research expertise in the areas of interventional and prospective
study design, decision making science & human-centered design, kidney transplant epidemiology, and research
dissemination & professional development. Upon completion of this project, he will have the scientific and
research expertise needed to be a grant-supported independent investigator in this field.

## Key facts

- **NIH application ID:** 10507025
- **Project number:** 1K23DK133729-01
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Syed Ali Husain
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $165,456
- **Award type:** 1
- **Project period:** 2022-08-01 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10507025

## Citation

> US National Institutes of Health, RePORTER application 10507025, Using Decision Making Science to Optimize Deceased Donor Kidney Allocation (1K23DK133729-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10507025. Licensed CC0.

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