Allograft Quality Not the Sole Reason for Turning Down Kidney
There was a correlation for later acceptance in the match-run with delayed graft function, but not with all-cause graft failure.
(HealthDay News) — Characteristics unrelated to allograft quality are associated with later acceptance in the deceased donor kidney match-run, including holiday or weekend procurement and shorter donor stature, according to a study published online in the American Journal of Transplantation.
Jordana B. Cohen, MD, from the University of Pennsylvania in Philadelphia, and colleagues conducted a retrospective cohort study involving 47,563 deceased donor kidney match-runs from 2007 to 2013.
The researchers observed independent associations for several characteristics unrelated to allograft quality with later acceptance in the match-run: Public Health Service increased-risk donor status (adjusted odds ratio [aOR], 2.49; 95% confidence interval [CI], 2.29 to 2.69), holiday or weekend procurement (aOR, 1.11; 95% CI, 1.07 to 1.16), shorter donor stature (aOR, 1.53 for <150 cm vs reference >180 cm; 95% CI, 1.28 to 1.94), and procurement in an area with higher intensity of market competition and with the longest waiting times (aORs, 1.71 [95% CI, 1.62 to 1.78] and 1.41 [95% CI, 1.34 to 1.49], respectively). There was a correlation for later acceptance in the match-run with delayed graft function, but not with all-cause graft failure (adjusted hazard ratio, 1.01; 95% CI, 0.96 to 1.07).
"Interventions are needed to reduce turndowns of viable organs, especially when decisions are driven by infectious risk, weekend or holiday procurement, geography, or other donor characteristics unrelated to allograft quality," the authors write.
- Cohen JB, Shults J, Goldberg DS, et al. Kidney allograft offers: Predictors of turndown and the impact of late organ acceptance on allograft survival. Am J Transplant. 31 July 2017. doi: 10.1111/ajt.14449