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Nonutilization of Kidneys From Donors After Circulatory Determinant of Death

BACKGROUND. The expansion of donation after circulatory determination of death (DCDD) programs and unmet demands for kidney transplantation indicate that there is a need to improve the efficiency and utilization of these organs. METHODS. We studied all DCDD donors retrieved for kidney transplantatio...

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Autores principales: Lin, Yingxin, Teixeira-Pinto, Armando, Opdam, Helen, Chapman, Jeremy R., Craig, Jonathan C., Rogers, Natasha, Pleass, Henry, Davies, Christopher, McDonald, Stephen, Yang, Jean, Lim, Wai, Wong, Germaine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9197368/
https://www.ncbi.nlm.nih.gov/pubmed/35721459
http://dx.doi.org/10.1097/TXD.0000000000001331
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author Lin, Yingxin
Teixeira-Pinto, Armando
Opdam, Helen
Chapman, Jeremy R.
Craig, Jonathan C.
Rogers, Natasha
Pleass, Henry
Davies, Christopher
McDonald, Stephen
Yang, Jean
Lim, Wai
Wong, Germaine
author_facet Lin, Yingxin
Teixeira-Pinto, Armando
Opdam, Helen
Chapman, Jeremy R.
Craig, Jonathan C.
Rogers, Natasha
Pleass, Henry
Davies, Christopher
McDonald, Stephen
Yang, Jean
Lim, Wai
Wong, Germaine
author_sort Lin, Yingxin
collection PubMed
description BACKGROUND. The expansion of donation after circulatory determination of death (DCDD) programs and unmet demands for kidney transplantation indicate that there is a need to improve the efficiency and utilization of these organs. METHODS. We studied all DCDD donors retrieved for kidney transplantation in Australia between 2014 and 2019 and determined the factors associated with nonutilization using least absolute shrinkage and selection operator and random forest models. Self-organizing maps were used to group these donors into clusters with similar characteristics and features associated with nonutilization were defined. RESULTS. Of the 762 DCDD donors, 116 (15%) were not utilized for kidney transplantation. Of the 9 clusters derived from self-organizing map, 2 had the highest proportions of nonutilized kidneys. Factors for nonutilization (adjusted odds ratio [95% confidence interval], per SD increase) were duration from withdrawal of cardiorespiratory support till death (1.38 [1.16-1.64]), admission and terminal serum creatinine (1.43 [1.13-1.85]) and (1.41 [1.16-1.73]). Donor kidney function and duration of warm ischemia were the main factors for clinical decisions taken not to use kidneys from DCDD donors. CONCLUSIONS. Donor terminal kidney function and the duration of warm ischemia are the key factors for nonutilization of DCDD kidneys. Strategies to reduce the duration of warm ischemia and improve post-transplant recipient kidney function may reduce rates of nonutilization.
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spelling pubmed-91973682022-06-16 Nonutilization of Kidneys From Donors After Circulatory Determinant of Death Lin, Yingxin Teixeira-Pinto, Armando Opdam, Helen Chapman, Jeremy R. Craig, Jonathan C. Rogers, Natasha Pleass, Henry Davies, Christopher McDonald, Stephen Yang, Jean Lim, Wai Wong, Germaine Transplant Direct Organ Donation and Procurement BACKGROUND. The expansion of donation after circulatory determination of death (DCDD) programs and unmet demands for kidney transplantation indicate that there is a need to improve the efficiency and utilization of these organs. METHODS. We studied all DCDD donors retrieved for kidney transplantation in Australia between 2014 and 2019 and determined the factors associated with nonutilization using least absolute shrinkage and selection operator and random forest models. Self-organizing maps were used to group these donors into clusters with similar characteristics and features associated with nonutilization were defined. RESULTS. Of the 762 DCDD donors, 116 (15%) were not utilized for kidney transplantation. Of the 9 clusters derived from self-organizing map, 2 had the highest proportions of nonutilized kidneys. Factors for nonutilization (adjusted odds ratio [95% confidence interval], per SD increase) were duration from withdrawal of cardiorespiratory support till death (1.38 [1.16-1.64]), admission and terminal serum creatinine (1.43 [1.13-1.85]) and (1.41 [1.16-1.73]). Donor kidney function and duration of warm ischemia were the main factors for clinical decisions taken not to use kidneys from DCDD donors. CONCLUSIONS. Donor terminal kidney function and the duration of warm ischemia are the key factors for nonutilization of DCDD kidneys. Strategies to reduce the duration of warm ischemia and improve post-transplant recipient kidney function may reduce rates of nonutilization. Lippincott Williams & Wilkins 2022-05-13 /pmc/articles/PMC9197368/ /pubmed/35721459 http://dx.doi.org/10.1097/TXD.0000000000001331 Text en Copyright © 2022 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Organ Donation and Procurement
Lin, Yingxin
Teixeira-Pinto, Armando
Opdam, Helen
Chapman, Jeremy R.
Craig, Jonathan C.
Rogers, Natasha
Pleass, Henry
Davies, Christopher
McDonald, Stephen
Yang, Jean
Lim, Wai
Wong, Germaine
Nonutilization of Kidneys From Donors After Circulatory Determinant of Death
title Nonutilization of Kidneys From Donors After Circulatory Determinant of Death
title_full Nonutilization of Kidneys From Donors After Circulatory Determinant of Death
title_fullStr Nonutilization of Kidneys From Donors After Circulatory Determinant of Death
title_full_unstemmed Nonutilization of Kidneys From Donors After Circulatory Determinant of Death
title_short Nonutilization of Kidneys From Donors After Circulatory Determinant of Death
title_sort nonutilization of kidneys from donors after circulatory determinant of death
topic Organ Donation and Procurement
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9197368/
https://www.ncbi.nlm.nih.gov/pubmed/35721459
http://dx.doi.org/10.1097/TXD.0000000000001331
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