Can Behavioral Research Improve Transplant Decision-Making? A Mock Offer Study on the Role of Biopsies

Background: The use of procurement biopsies for assessing kidney quality has been implicated as a driver of the nearly 20% US kidney discard rate. Yet in some contexts, biopsies may boost clinical confidence, enabling acceptance of kidneys that would otherwise be discarded. We leveraged a novel organ offer simulation platform to conduct a controlled experiment isolating biopsy effects on offer acceptance decisions. Methods: Between November 26 and December 14, 2018, 41 kidney transplant surgeons and 27 transplant nephrologists each received the same 20 hypothetical kidney offers using a cross-over design with weekend "washout" periods. Mini-study 1 included four, low serum creatinine (