The Effect of the Procurement Surgeon on Transplanted Abdominal Organ Outcomes: An OPTN/SRTR Analysis to Evaluate Regional Organ Procurement Collaboration.
1Surgery, University of Minnesota, Minneapolis, MN
2Biostatistics, University of Minnesota, Minneapolis, MN
Meeting: 2017 American Transplant Congress
Abstract number: 470
Keywords: Kidney transplantation, Liver transplantation, Pancreas transplantation, Surgical complications
Session Information
Session Name: Concurrent Session: Surgical Issues (Minimally Invasive/Open): All Organs
Session Type: Concurrent Session
Date: Tuesday, May 2, 2017
Session Time: 2:30pm-4:00pm
Presentation Time: 3:06pm-3:18pm
Location: E451a
OBJECTIVE: A number of single center studies have demonstrated utility of regional organ procurement collaboration to reduce travel redundancy by procuring surgical teams with no difference in transplanted organ outcomes for a variety of abdominal organs.
METHODS: We studied outcomes for kidney (K), liver (L), and pancreas (P) grafts from deceased donors transplanted between January 1, 2002 and December 31, 2014 using the Scientific Registry of Transplant Recipients (SRTR). We compared outcomes between organs procured by the recipient's center (transplant procurement team; TPT) versus non-TPT (NTPT). To assess the effect of TPT on graft survival (GS), death-censored graft survival (DCGS), and overall survival (OS), we fit a mixed-effect Cox proportional hazards model adjusting for procurement team; recipient and donor demographics; surgical technique. Transplant center and volume was included as a random effect in the model. A similar mixed-effect logistic model was fit for DGF for K.
RESULTS: Between 2002 and 2014, there were 114,522 K (25.9% TPT), 61,900 L (61.9% TPT), 4,181 P alone (38.2% TPT), and 9,423 KP (57.2% TPT). When compared to NTPT, GS for organs procured by TPT was significantly better for K (adjusted HR: 0.96; 95% CI: 0.93-0.99) and KP (0.88; 0.81-0.96), marginally significant for L (0.97; 0.94-1.00), and not for P (1.05; 0.95 -1.17). Adjusted 3-year DCGS comparing TPT to NTPT was 83.2% vs 82.2% (p<0.001) for K, 76.9% vs 75.6% (p<0.001) for L, and 81.9% vs 80.2% (p<0.001) for KP. DCGS was significantly better comparing TPT to NTPT for K, L, and KP, but OS was not significantly distinct among the procurement cohorts for any graft (Table 1). DGF for TPT K was significantly lower (adjusted OR 0.88; 0.84-0.91). 
CONCLUSION: Our findings contradict previous support for regional organ procurement collaboration. These results may justify the economic and personnel investment TPT devote to procuring these organs.
CITATION INFORMATION: Serrano O, Vock D, Kandaswamy R, Pruett T, Matas A, Finger E. The Effect of the Procurement Surgeon on Transplanted Abdominal Organ Outcomes: An OPTN/SRTR Analysis to Evaluate Regional Organ Procurement Collaboration. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Serrano O, Vock D, Kandaswamy R, Pruett T, Matas A, Finger E. The Effect of the Procurement Surgeon on Transplanted Abdominal Organ Outcomes: An OPTN/SRTR Analysis to Evaluate Regional Organ Procurement Collaboration. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/the-effect-of-the-procurement-surgeon-on-transplanted-abdominal-organ-outcomes-an-optnsrtr-analysis-to-evaluate-regional-organ-procurement-collaboration/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress