Abstract
This study was performed to determine if organ selection practices for heart utilization by Region 9 transplant programs were optimal, and to identify opportunities to increase local organ recovery. A retrospective review of de-identified region-wide donor data January 1, 2010 through December 31, 2013 was performed. Over the study period 537 heart donors were identified, of which 321 (60%) were transplanted. Two hundred-sixteen consented hearts were not used; 190 of these were not recovered, and 26 were recovered but not transplanted. Of these, 245/321 (76%) hearts were transplanted at one of 5 regional programs, 15 (5%) were transplanted out of region as primary offers, and 61 (19%) were turned down in region and exported. Of the 61 exported hearts, 43 were turned down in region for donor-related "quality" codes (UNOS 830, 833-837) by at least one program, the remaining 18 hearts were turned down for non-"quality" reasons, primarily histocompatibility and size. Only 5/43 exported were turned down for "quality" reasons by all regional programs offered the organ. A review of consented, not recovered donor offers suggested an additional 28 organs were possibly appropriate for transplant. Our review of regional turn-downs suggests transplant centers could potentially identify additional usable organs without compromising short-term outcomes.
| Original language | English (US) |
|---|---|
| Journal | American Journal of Transplantation |
| DOIs | |
| State | Accepted/In press - 2017 |
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Keywords
- Clinical research/practice
- Donors and donation
- Heart (allograft) function/dysfunction
- Heart transplantation/cardiology
- Organ procurement and allocation
ASJC Scopus subject areas
- Immunology and Allergy
- Transplantation
- Pharmacology (medical)
Cite this
Maximizing donor allocation : A review of UNOS region 9 donor heart turn-downs. / Mancini, Donna; Goldstein, Daniel J.; Taylor, Samantha; Chen, Leway; Gass, Alan; Delair, Samantha; Pinney, Sean.
In: American Journal of Transplantation, 2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Maximizing donor allocation
T2 - A review of UNOS region 9 donor heart turn-downs
AU - Mancini, Donna
AU - Goldstein, Daniel J.
AU - Taylor, Samantha
AU - Chen, Leway
AU - Gass, Alan
AU - Delair, Samantha
AU - Pinney, Sean
PY - 2017
Y1 - 2017
N2 - This study was performed to determine if organ selection practices for heart utilization by Region 9 transplant programs were optimal, and to identify opportunities to increase local organ recovery. A retrospective review of de-identified region-wide donor data January 1, 2010 through December 31, 2013 was performed. Over the study period 537 heart donors were identified, of which 321 (60%) were transplanted. Two hundred-sixteen consented hearts were not used; 190 of these were not recovered, and 26 were recovered but not transplanted. Of these, 245/321 (76%) hearts were transplanted at one of 5 regional programs, 15 (5%) were transplanted out of region as primary offers, and 61 (19%) were turned down in region and exported. Of the 61 exported hearts, 43 were turned down in region for donor-related "quality" codes (UNOS 830, 833-837) by at least one program, the remaining 18 hearts were turned down for non-"quality" reasons, primarily histocompatibility and size. Only 5/43 exported were turned down for "quality" reasons by all regional programs offered the organ. A review of consented, not recovered donor offers suggested an additional 28 organs were possibly appropriate for transplant. Our review of regional turn-downs suggests transplant centers could potentially identify additional usable organs without compromising short-term outcomes.
AB - This study was performed to determine if organ selection practices for heart utilization by Region 9 transplant programs were optimal, and to identify opportunities to increase local organ recovery. A retrospective review of de-identified region-wide donor data January 1, 2010 through December 31, 2013 was performed. Over the study period 537 heart donors were identified, of which 321 (60%) were transplanted. Two hundred-sixteen consented hearts were not used; 190 of these were not recovered, and 26 were recovered but not transplanted. Of these, 245/321 (76%) hearts were transplanted at one of 5 regional programs, 15 (5%) were transplanted out of region as primary offers, and 61 (19%) were turned down in region and exported. Of the 61 exported hearts, 43 were turned down in region for donor-related "quality" codes (UNOS 830, 833-837) by at least one program, the remaining 18 hearts were turned down for non-"quality" reasons, primarily histocompatibility and size. Only 5/43 exported were turned down for "quality" reasons by all regional programs offered the organ. A review of consented, not recovered donor offers suggested an additional 28 organs were possibly appropriate for transplant. Our review of regional turn-downs suggests transplant centers could potentially identify additional usable organs without compromising short-term outcomes.
KW - Clinical research/practice
KW - Donors and donation
KW - Heart (allograft) function/dysfunction
KW - Heart transplantation/cardiology
KW - Organ procurement and allocation
UR - http://www.scopus.com/inward/record.url?scp=85030550973&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85030550973&partnerID=8YFLogxK
U2 - 10.1111/ajt.14499
DO - 10.1111/ajt.14499
M3 - Article
C2 - 28898542
AN - SCOPUS:85030550973
JO - American Journal of Transplantation
JF - American Journal of Transplantation
SN - 1600-6135
ER -