Hard-to-place kidney offers: Donor- and system-level predictors of discard

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
J Reinier F NarvaezLiise K Kayler

Abstract

Understanding risk factors for deceased-donor kidney nontransplantation is important since discard rates remain high. We analyzed DonorNet® data of consecutive deceased-donor nonmandatory share primary kidney-only offers to adult candidates at our center and beyond between July 1, 2015 and March 31, 2016 for donor- and system-level risk factors of discard, defined as nontransplantation at our or subsequent transplant centers. Exclusions were hepatitis C virus/hepatitis B virus core antibody status, blood type AB, and donor <1 year based on low candidate waitlist size. Of 456 individual kidney offers, from 296 donors, 73% were discarded. Most were national (93%) offers from Kidney Donor Profile Index 35-85% (n = 233) or >85% (n = 208) donors late in the allocation sequence with prior refusals logged for numerous candidates. On multivariate regression, factors significantly associated with discard were donor cerebrovascular accident (adjusted odds ratio [aOR]: 3.32), cancer transmission concern (aOR: 6.5), renal artery luminal compromise (aOR: 3.97), biopsy score ≥3 (aOR: 5.09), 2-hour pump resistive index >0.4 (aOR: 3.27), absence of pump (aOR: 2.58), nonspecific kidney abnormality (aOR: 2.76), increasing offer cold ischemia tim...Continue Reading

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Citations

Dec 7, 2018·Current Opinion in Organ Transplantation·Neeraj SharmaYasir A Qazi
Apr 20, 2018·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·J B CohenP P Reese
Feb 20, 2021·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Mathew Brent PriceAbbas Rana
Aug 19, 2020·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Fatemeh KaramiSommer E Gentry
Jul 3, 2021·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Liise K KaylerKatia Noyes
Dec 31, 2021·Clinical Transplantation·Nikolas H ZaphirosLiise K Kayler

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