The discard rate of potentially usable kidneys remains dismal despite a critical shortage of organs. The Scientific Registry of Transplant Recipients (SRTR) now provides a report on the number of "Hard to Place "(HTPK) offers made to a Transplant center along with a regional and national comparisons. HTPK are defined as kidney offers requiring more than a 100 offers before having been accepted by a centerAim:The purpose of our study was to analyze the data of HTPK accepted at our center. Methods : HTPK accepted at our center during the period of 6/2016 to 7/2017 was analyzed. Data Collected : Donor age , recipient age, KDPI, CIT, Mismatch Induction agent. Pt and graft survival, 1,3, 6, 12 mo Cr Results : A total of 66 kidneys were accepted at our center during this period. 63 had a follow up of at least 6 months and 33 for 12 month data points. 52 of these kidneys had undergone a biopsy at procurement. Results : The mean donor age was 43.53 years(17-64 ), recipient age was 57.82 years (25-74), KDPI 59.9(6-97), CIT 24.19 hours ( 4-45), Mismatch 3.9 (0-6). All but 2 received Thymoglobulin for induction. The 1,3,6, 12 mo cr in mg/dl were 1.8 (0.8-7.4), 1.41 (0.6-3) ), 1.47 (0.6-5.9), 1.6 (0.7-6.7) respectively. 3 grafts were lost ( 2 to surgical complications and 1 to FSGS recurrence). The most common reason for the kidneys having been declined at other centers was donor quality. HTPK accounted for close to 45% of the DDTx performed at our center during this time period and despite their use, the outcomes at our center have been statistically higher that national standards. Conclusion : This single center analysis of HTPK shows that when carefully selected, excellent results are achievable without any impact on centers outcomes or ratings. Other centers should emulate strategies used by aggressive centers to reduce the overall discard rates of these organs.

CITATION INFORMATION: Qazi Y., Lee K., Jones A., Aguirre L., Parma M., Smogorzewski M., Maw T. T., Sher L. A Single Center Outcomes Analysis of UNOS Defined "Hard to Place Kidneys" Am J Transplant. 2017;17 (suppl 3).

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