Deteriorating Quality of Organ Donors, The
Hepatopancreatobiliary and Transplant Surgery, McGill University, Montreal, Canada
Surgery, King Saud University, Riyadh, Saudi Arabia
Meeting: 2013 American Transplant Congress
Abstract number: C1245
Purpose
With the rising disparity between the number of transplants needed and the number of organ donors available, there is an increasing trend of procuring organs that fit the extended donor criteria. Often, these organs are of poorer quality and result in inferior outcome. The purpose of this study was to evaluate the quality of donors at our centre.
Methods
Data was obtained from the prospectively collected transplantation database. A total of 1041 brain-dead organ donors between 2000 and 2012 were reviewed in order to analyze the change in donor characteristics between donors prior to and including 2005 and after 2005. Exclusions included living related or donation after cardiac death donors.
Results
The mean age was 45.3 ± 17.2 years and 575 (56.3%) donors were men. The average body mass index (BMI) was 27.6 ± 11.3 kg/m2. The median calculated creatinine clearance was 111.3 (interquartile range of 77.25-133.47 ml/min). There were 445 smokers (42.8%) and 50 (11.2%) who had history of coronary artery disease (CAD). There were 125 (12.0%) with hyperlipidemia and 45 (4.3%) had active infection. Multivariate logistic regression analysis revealed that after 2005, donors were more likely to have the characteristics shown in Table 1 after 2005 compared to the earlier period. The following variables were significantly different in donors of the period 2006-2012 compared to 2000-2005: Male gender (50.8% vs. 49.2%, OR=1.43), age less than 30 (51.3% vs. 48.7%, OR=1.73), BMI greater than 30 kg/m2 (64.0% vs. 36.0%, OR=2.42), smoking (69.7% vs. 30.3% OR=3.96), presence of CAD (83% vs. 17.0% OR=2.39), presence of hyperlipidemia (83.2% vs. 16.8 %, OR=3.88), upper quartile creatinine clearance (OR=1.67), non-Caucasian race(OR=2.49), and less infection (13.3% vs. 86.7%, OR=0.18).
| Donor characteristic | OR (95% CI) | P value |
| Male gender | 1.43 (1.00-2.03) | 0.045 |
| Age < 30 | 1.73 (1.08-2.77) | 0.022 |
| BMI > 30 | 2.42 (1.45-4.03) | 0.001 |
| Smoking | 3.96 (2.77-5.65) | <0.001 |
| CAD | 2.39 (1.19-4.79) | 0.014 |
| Hyperlipidemia | 3.88 (2.02-7.44) | <0.001 |
| Upper Quartile Creatinine Clearance | 1.67 (1.01-2.76) | 0.046 |
| Non-Caucasian | 2.49 (0.98-6.33) | 0.055 |
| Infection | 0.18 (0.07-0.51) | 0.001 |
Conclusion
The quality of brain dead organ donors has deteriorated over the past decade. Technology should be focused on improving the quality of these extended criteria donors in the absence of good alternatives.
To cite this abstract in AMA style:
Aloraini A, Simoneau E, Doi S, Ali S, Tchervenkov J, Metrakos P, Hassanain M. Deteriorating Quality of Organ Donors, The [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/deteriorating-quality-of-organ-donors-the/. Accessed November 22, 2024.« Back to 2013 American Transplant Congress