Project Grant R01DK149346

The National Institute of Diabetes and Digestive and Kidney Diseases awarded The Research Foundation for the State University of New York $327,450 on August 20, 2026, under the Diabetes, Digestive, and Kidney Diseases Extramural Research program (CFDA 93.847) to conduct research on reducing geographic disparity in access to deceased donor kidney transplantation.

The recipient will employ advanced statistical methods, artificial intelligence, and operations research to understand complex dynamics within the organ allocation system and inform policy changes that reduce geographic disparity while mitigating unintended systemic inefficiencies. The research addresses three specific aims: determining the causal effect of allocation out-of-sequence on geographic disparity; characterizing the interplay between geographic disparity and transplant center organ acceptance behavior over time; and identifying optimal kidney allocation boundaries that jointly minimize geographic disparity and organ transplantation system inefficiencies. The work responds to substantial geographic variation in deceased donor kidney transplant wait times, which currently vary up to tenfold across the United States and contribute to approximately half of waitlist candidates becoming too ill for transplant. A 2021 organ allocation policy designed to reduce this disparity through wider organ sharing has created unintended consequences including increased wait time uncertainty and higher organ non-use rates.

Performance occurs in Buffalo, New York, with a period of performance from August 20, 2026, through May 31, 2031. The Research Foundation for the State University of New York serves as fiscal agent for the State University of New York system.