Centers for Disease Control ‘High‐Risk’ Donors and Kidney Utilization

• Published in: American journal of transplantation Vol. 10; no. 2; pp. 416 - 420
• Main Authors: Duan, K. I., Englesbe, M. J., Volk, M. L.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01-02-2010; Wiley
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Centers for Disease Control and Prevention, U.S; Clinical death. Palliative care. Organ gift and preservation; Disease transmission; extended criteria donors; General aspects; Humans; Kidney - surgery; kidney transplantation; Medical sciences; Odds Ratio; organ donation; organ utilization; Registries; Risk Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Tissue Donors - statistics & numerical data; United States; United States; Suboptimal donor; Human; High risk; Center; Disease; organ utilization; Use; Transmission; Check; Homotransplantation; Kidney; Ethics; Organ donation; Treatment; Disease transmission; extended criteria donors; Urinary system; Surveillance; Criterion; Surgery; Graft; Organ; Kidney transplantation
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/j.1600-6143.2009.02931.x

The aims of this study were to determine whether Centers for Disease Control high risk (CDCHR) status of organ donors affects kidney utilization and recipient survival. Data from the Scientific Registry of Transplant Recipients were used to examine utilization rates of 45 112 standard criteria donor (SCD) deceased donor kidneys from January 1, 2005, and February 2, 2009. Utilization rates for transplantation were compared between CDCHR and non‐CDCHR kidneys, using logistic regression to control for possible confounders. Cox regression was used to determine whether CDCHR status independently affected posttransplant survival among 25 158 recipients of SCD deceased donor kidneys between January 1, 2005, and February 1, 2008. CDCHR kidneys were 8.2% (95% CI 6.9–9.5) less likely to be used for transplantation than non‐CDCHR kidneys; after adjusting for other factors, CDCHR was associated with an odds ratio of utilization of 0.67 (95% CI 0.61–0.74). After a median 2 years follow‐up, recipients of CDCHR kidneys had similar posttransplant survival compared to recipients of non‐CDCHR kidneys (hazard ratio 1.06, 95% CI 0.89–1.26). These findings suggest that labeling donor organs as ‘high risk’ may result in wastage of approximately 41 otherwise standard kidneys per year.
Kidneys from CDC High Risk donors were less likely to be used for transplantation than kidneys from non‐CDC High Risk donors, despite being associated with similar patient survival.