Increasing the Number of Organ Transplants in the United States by Optimizing Donor Authorization Rates
While recent policies have focused on allocating organs to patients most in need and lessening geographic disparities, the only mechanism to increase the actual number of transplants is to maximize the potential organ supply. We conducted a retrospective cohort study using OPTN data on all “eligible...
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Veröffentlicht in: | American journal of transplantation 2015-08, Vol.15 (8), p.2117-2125 |
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creator | Goldberg, D. S. French, B. Abt, P. L. Gilroy, R. K. |
description | While recent policies have focused on allocating organs to patients most in need and lessening geographic disparities, the only mechanism to increase the actual number of transplants is to maximize the potential organ supply. We conducted a retrospective cohort study using OPTN data on all “eligible deaths” from 1/1/08 to 11/1/13 to evaluate variability in donor service area (DSA)‐level donor authorization rates, and to quantify the potential gains associated with increasing authorization rates. Despite adjustments for donor demographics (age, race/ethnicity, cause of death) and geographic factors (rural/urban status of donor hospital, statewide participation in deceased‐donor registries) among 52 571 eligible deaths, there was significant variability (p |
doi_str_mv | 10.1111/ajt.13362 |
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Using six years of eligible death data from the OPTN, the authors demonstrate that OPO‐level donor authorization rates vary across the 58 OPOs, and significant opportunity exists to improve rates to bridge the organ supply–demand mismatch. See editorial from Luskin and Nathan on page 2019.</description><identifier>ISSN: 1600-6135</identifier><identifier>EISSN: 1600-6143</identifier><identifier>DOI: 10.1111/ajt.13362</identifier><identifier>PMID: 26031323</identifier><language>eng</language><publisher>United States: Elsevier Limited</publisher><subject>donors and donation ; donors and donation: donation after brain death (DBD) ; Humans ; organ procurement ; organ procurement organization ; Organ Transplantation - statistics & numerical data ; Tissue Donors ; Transplants & implants</subject><ispartof>American journal of transplantation, 2015-08, Vol.15 (8), p.2117-2125</ispartof><rights>Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons</rights><rights>Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4582-d7ca82bd4ab47821ce97f340c7d07df8669132d10c891d4233950c1c37505b43</citedby><cites>FETCH-LOGICAL-c4582-d7ca82bd4ab47821ce97f340c7d07df8669132d10c891d4233950c1c37505b43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fajt.13362$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fajt.13362$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26031323$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Goldberg, D. S.</creatorcontrib><creatorcontrib>French, B.</creatorcontrib><creatorcontrib>Abt, P. L.</creatorcontrib><creatorcontrib>Gilroy, R. K.</creatorcontrib><title>Increasing the Number of Organ Transplants in the United States by Optimizing Donor Authorization Rates</title><title>American journal of transplantation</title><addtitle>Am J Transplant</addtitle><description>While recent policies have focused on allocating organs to patients most in need and lessening geographic disparities, the only mechanism to increase the actual number of transplants is to maximize the potential organ supply. We conducted a retrospective cohort study using OPTN data on all “eligible deaths” from 1/1/08 to 11/1/13 to evaluate variability in donor service area (DSA)‐level donor authorization rates, and to quantify the potential gains associated with increasing authorization rates. Despite adjustments for donor demographics (age, race/ethnicity, cause of death) and geographic factors (rural/urban status of donor hospital, statewide participation in deceased‐donor registries) among 52 571 eligible deaths, there was significant variability (p < 0.001) in donor authorization rates across the 58 DSAs. Overall DSA‐level adjusted authorization rates ranged from 63.5% to 89.5% (median: 72.7%). An additional 773–1623 eligible deaths could have been authorized, yielding 2679–5710 total organs, if the DSAs with authorization rates below the median and 75th percentile, respectively, implemented interventions to perform at the level of the corresponding reference DSA. Opportunities exist within the current organ acquisition framework to markedly improve DSA‐level donor authorization rates. Such initiatives would mitigate waitlist mortality while increasing the number of transplants.
Using six years of eligible death data from the OPTN, the authors demonstrate that OPO‐level donor authorization rates vary across the 58 OPOs, and significant opportunity exists to improve rates to bridge the organ supply–demand mismatch. See editorial from Luskin and Nathan on page 2019.</description><subject>donors and donation</subject><subject>donors and donation: donation after brain death (DBD)</subject><subject>Humans</subject><subject>organ procurement</subject><subject>organ procurement organization</subject><subject>Organ Transplantation - statistics & numerical data</subject><subject>Tissue Donors</subject><subject>Transplants & implants</subject><issn>1600-6135</issn><issn>1600-6143</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10MtOAjEUBuDGaATRhS9gmrjRBdDb3JYEbxgiieJ60ul0oIRpse3EwNNbLrIwsZvTxZc_5_wAXGPUw-H1-cL3MKUxOQFtHCPUjTGjp8c_jVrgwrkFQjghKTkHLRIjiimhbTAbaWEld0rPoJ9L-NbUhbTQVHBiZ1zDqeXarZZceweV3pFPrbws4YfnXjpYrOFk5VWtNtuIB6ONhYPGz41VG-6V0fB96y7BWcWXTl4dZgdMnx6nw5fuePI8Gg7GXcGilHTLRPCUFCXjBUtSgoXMkooyJJISJWWVxnEW9i4xEmmGS0YozSIksKBJhKKC0Q6428eurPlqpPN5rZyQy3CANI3LcZylNEOI4UBv_9CFaawOy21VQrM0Y1FQ93slrHHOyipfWVVzu84xyrfl56H8fFd-sDeHxKaoZXmUv20H0N-Db7WU6_-T8sHrdB_5A3j2jMc</recordid><startdate>201508</startdate><enddate>201508</enddate><creator>Goldberg, D. 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K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increasing the Number of Organ Transplants in the United States by Optimizing Donor Authorization Rates</atitle><jtitle>American journal of transplantation</jtitle><addtitle>Am J Transplant</addtitle><date>2015-08</date><risdate>2015</risdate><volume>15</volume><issue>8</issue><spage>2117</spage><epage>2125</epage><pages>2117-2125</pages><issn>1600-6135</issn><eissn>1600-6143</eissn><abstract>While recent policies have focused on allocating organs to patients most in need and lessening geographic disparities, the only mechanism to increase the actual number of transplants is to maximize the potential organ supply. We conducted a retrospective cohort study using OPTN data on all “eligible deaths” from 1/1/08 to 11/1/13 to evaluate variability in donor service area (DSA)‐level donor authorization rates, and to quantify the potential gains associated with increasing authorization rates. Despite adjustments for donor demographics (age, race/ethnicity, cause of death) and geographic factors (rural/urban status of donor hospital, statewide participation in deceased‐donor registries) among 52 571 eligible deaths, there was significant variability (p < 0.001) in donor authorization rates across the 58 DSAs. Overall DSA‐level adjusted authorization rates ranged from 63.5% to 89.5% (median: 72.7%). An additional 773–1623 eligible deaths could have been authorized, yielding 2679–5710 total organs, if the DSAs with authorization rates below the median and 75th percentile, respectively, implemented interventions to perform at the level of the corresponding reference DSA. Opportunities exist within the current organ acquisition framework to markedly improve DSA‐level donor authorization rates. Such initiatives would mitigate waitlist mortality while increasing the number of transplants.
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subjects | donors and donation donors and donation: donation after brain death (DBD) Humans organ procurement organ procurement organization Organ Transplantation - statistics & numerical data Tissue Donors Transplants & implants |
title | Increasing the Number of Organ Transplants in the United States by Optimizing Donor Authorization Rates |
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