Transplant Outcomes In Vulnerable Populations

Dr. Reese examines policies and practices that affect vulnerable populations with renal disease, especially related to organ allocation. This work has included studying processes of evaluating older individuals for kidney transplantation, balancing equity and utility in allocating organs across the lifespan, and applying evidence from randomized trials to this population.  In an article published in the Journal of the American Geriatrics Society, Dr. Reese proposed guidelines for using age in healthcare rationing and also proposed the novel use of functional status as a tool for organ allocation for kidney transplant candidates. He later demonstrated that functional status is a potent predictor of survival among kidney transplant recipients in the American Journal of Kidney Diseases. In demonstrating the exclusion of elderly kidney transplant recipients from clinical trials, Dr. Reese also revealed that much of the evidence used to care for kidney transplant patients may not be generalizable to the elderly and developed policy proposals to address the problem with colleagues from the FDA. Dr. Reese has also examined allocation priority for children on the kidney transplant waiting list, and the effects of multi-organ transplantation on access to transplant among children.