Healthcare professional and community preferences in deceased donor kidney allocation: A best-worst scaling survey

Matthew P. Sypek, Martin Howell, Kirsten Howard, Germaine Wong, Emily Duncanson, Philip D. Clayton, Peter Hughes, Stephen McDonald

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Deceased donor kidneys are a scarce community resource; therefore, the principles underpinning organ allocation should reflect societal values. This study aimed to elicit community and healthcare professional preferences for principles guiding the allocation of kidneys from deceased donors and compare how these differed across the populations. A best-worst scaling survey including 29 principles in a balanced incomplete block design was conducted among a representative sample of the general community (n = 1237) and healthcare professionals working in transplantation (n = 206). Sequential best-worst multinomial logistic regression was used to derive scaled preference scores (PS) (range 0–100). Thematic analysis of free text responses was performed. Five of the six most valued principles among members of the community related to equity, including priority for the longest waiting (PS 100), difficult to transplant (PS 94.5) and sickest (PS 93.9), and equitable access for men and women (PS 94.0), whereas the top four principles for healthcare professional focused on maximizing utility (PS 89.9–100). Latent class analysis identified unmeasured class membership among community members. There are discordant views between community members and healthcare professionals. These should be considered in the design, evaluation, and implementation of deceased donor kidney allocation protocols.

Original languageEnglish
Pages (from-to)886-897
Number of pages12
JournalAmerican Journal of Transplantation
Issue number3
Publication statusPublished or Issued - Mar 2022


  • clinical research
  • donors and donation
  • ethics
  • ethics and public policy
  • kidney transplantation
  • nephrology
  • organ allocation
  • organ procurement and allocation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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