*Purpose: As the number of patients awaiting kidney transplantation increases from year to year, centers must maximize efforts to transplant kidneys procured. One way of approaching this is to minimize the rate of discasrded kidneys. As such, we examined discard data from kidneys procured in a multi-center OPO in UNOS Region 11.

*Methods: Data from discarded kidneys between 2017 and 2018 was obtained for retrospective analysis. Donor factors including laterality, sex, age, biopsy, KDPI, terminal creatinine and whether the kidney was pumped was analyzed.

*Results: 637 procured kidneys between 2017 (n = 371) and 2018 (n = 266) were analyzed to assess for trends in discard rates. Discarded kidneys came from older donors (average age 40.4 +/- 18.9, p <0.0001) with almost similar KDPI values (45.9 +/- 25.3 for transplanted kidneys versus 53.5 +/- 29 for discarded kidneys, p = 0.0005). Further analysis revealed that of those kidneys discarded, 77.5% had a KDPI < 85%. 263 kidneys which were transplanted underwent biopsy (41.5 %), while 370 (58.5%) did not, p = 0.081. Lastly, transplanted kidneys were pumped 37.2% (n = 236), while discarded kidneys were pumped 62.8% (n = 399), p <0.0001.

*Conclusions: Discard rates decreased during the 2018 calender year which correlated with our OPO implementing quarterly transplant center analysis of utilization. Expanding this type of review to all OPO’s may increase utilization rates. Furthermore, it appears that kidneys undergoing biopsy and pump did not correlate, suggesting that regardless of the presence of a biopsy, consideration should be made to pump kidneys to see if they are suitable for transplantation. Based on these initial findings, further investigation is currently underway to determine if discard rates can be further minimized.

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