Joel T Adler, David C Cron, Arnold E Kuk, Miko Yu, Sumit Mohan, S Ali Husain, Layla Parast
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引用次数: 0
Abstract
Out of sequence (OOS) kidney allocation has become increasingly prevalent since 2021. We examined the relationship between Organ Procurement Organization (OPO) OOS allocation frequency and kidney non-use rates. Among 57 OPOs between March 2021 and December 2023, we analyzed trends in OOS utilization and its association with kidney non-use rates. There was significant variability in OOS use across OPOs, with some allocating over 20% of kidneys out of sequence over the entire period. An absolute increase of 1 standard deviation (12.8%) of OOS allocation was modestly associated with a reduction in kidney non-use rates (IRR 0.98, P = 0.04). Donor characteristics, particularly older age, donation after circulatory death, and high kidney donor profile index, were the strongest predictors of non-use. While OOS allocation may mitigate logistical challenges, other strategies may be more effective at reducing the non-use rate.
期刊介绍：
The American Journal of Transplantation is a leading journal in the field of transplantation. It serves as a forum for debate and reassessment, an agent of change, and a major platform for promoting understanding, improving results, and advancing science. Published monthly, it provides an essential resource for researchers and clinicians worldwide.
The journal publishes original articles, case reports, invited reviews, letters to the editor, critical reviews, news features, consensus documents, and guidelines over 12 issues a year. It covers all major subject areas in transplantation, including thoracic (heart, lung), abdominal (kidney, liver, pancreas, islets), tissue and stem cell transplantation, organ and tissue donation and preservation, tissue injury, repair, inflammation, and aging, histocompatibility, drugs and pharmacology, graft survival, and prevention of graft dysfunction and failure. It also explores ethical and social issues in the field.
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