Impact of the Weekend Effect on Adult and Pediatric Liver or Kidney Offer Acceptance

T. Yamamoto, M. Fruscione, A. Shah, L. Dageforde, S. Kimura, H. Yeh, N. Elias, T. Kawai, J. F. Markmann

Transplant Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, MA

Meeting: 2022 American Transplant Congress

Abstract number: 1338

Keywords: Allocation, Graft acceptance, Kidney transplantation, Liver transplantation

Topic: Clinical Science » Public Policy » 21 - Non-Organ Specific: Public Policy & Allocation

Session Information

Session Name: Non-Organ Specific: Public Policy & Allocation

Session Type: Poster Abstract

Date: Monday, June 6, 2022

Session Time: 7:00pm-8:00pm

Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: Weekends may impose resource and manpower constraints on hospitals. Studies using data from prior allocation schemas showed increased adult organ discards on weekends. We examined the impact of day of week on adult and pediatric organ acceptance using contemporary data.

*Methods: Retrospective analysis of UNOS-PTR match-run data of all offers for potential kidney and liver transplant from 1/1/2016-7/1/2021 were examined to study rate at which initial offers were declined depending on day of the week. Risk factors for decline were also evaluated.

*Results: In this study, potential deceased adult (donor age≧18yo) donor kidneys (n=101,395) and livers (n=45,168) as well as pediatric (donor age <18yo) donor kidneys (n=7,999) and livers (n=4,308) were examined. Of the total initial adult and pediatric liver and kidney offers, the fewest offers occurred on Monday and Sunday. On the other hand, the most adult liver and kidney offers occurred on Wednesday, the most pediatric kidney offers occurred on Friday and the most pediatric liver offers occurred on Thursday (Figure1). The decline rate for adult kidneys was the highest on Saturday (12.5%) and lowest on Tuesday (10.7%). Similarly, the rate for pediatric kidneys was the highest on Saturday (8.4%) and Sunday (8.4%) and lowest on Tuesday (6.8%). The rate for adult livers was highest on Saturday (7.8%) and lowest on Wednesday (6.2%). On the other hand, the rate for pediatric liver was the highest on Tuesday (7.3%) and lowest on Wednesday (5.3%). Independent risk factors (p<0.05) from multivariate analysis of the adult and pediatric kidney or livers decline rate are analyzed and the weekend (Sat/Sun) offer remains an independent risk factor for adult kidney or liver offers (kidney:OR:1.11, liver:OR:1.11) for declines. On the other hand, the weekend offer wasn`t an independent risk factor for pediatric kidney or liver offers for declines.

*Conclusions: Even though allocation systems have changed, and the availability of kidneys and livers have increased in the USA over the past 5 years, the weekend effect remains significant for adult liver and kidney offers for declines. Interestingly, the weekend effect was not evident for pediatric liver and kidney offers. Manpower differences on the weekend our contribute to the offer decline imbalance and strategies should be devised to better synchronize manpower and organ availability.

To cite this abstract in AMA style:

Yamamoto T, Fruscione M, Shah A, Dageforde L, Kimura S, Yeh H, Elias N, Kawai T, Markmann JF. Impact of the Weekend Effect on Adult and Pediatric Liver or Kidney Offer Acceptance [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-the-weekend-effect-on-adult-and-pediatric-liver-or-kidney-offer-acceptance/. Accessed May 11, 2025.

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