The effect of an organ procurement organization surgeon on pediatric organ utilization

Author:

Hwang Christine S.12ORCID,Shubin Andrew D.1ORCID,Patel Madhukar S.1,Reese Jeffrey C.3,Sanchez‐Vivaldi Jorge A.1,Desai Dev M.12,Vagefi Parsia A.1,MacConmara Malcolm4ORCID

Affiliation:

1. Division of Surgical Transplantation, Department of Surgery University of Texas Southwestern Medical Center Dallas Texas USA

2. Division of Pediatric Transplantation Children's Medical Center Dallas Texas USA

3. LifeGift Fort Worth Texas USA

4. TransMedics Inc. Andover Massachusetts USA

Abstract

AbstractIntroductionOrgan procurement organizations (OPO) have started to employ transplant‐trained surgeons dedicated to organ procurement with the aim to increase allograft utilization and enhance the use of procured organs. We investigated the effects of an OPO‐employed surgeon on the procurement and utilization of organs from pediatric donors within the Southwestern Transplant Alliance OPO.MethodsOPO data were obtained for all procurements that were performed between 2014 and 2019. The analysis was performed to see if the presence of an OPO donor surgeon impacted the utilization of pediatric livers. Donor and recipient demographic data were examined between allografts procured with the presence of an OPO surgeon (OPO‐Present) and those without an OPO surgeon (OPO‐Absent). A p‐value of <.05 was considered significant.ResultsOf 149 pediatric procurements, 91 included an OPO‐donor surgeon. In procurements with OPO‐Present, donors were younger (8.2 vs. 11.2, p < .05) and had longer distances to travel to the recipient center (334 vs. 175 miles p < .05), but had comparable cold ischemic times. In terms of organ share type, more OPO‐Present livers were shared nationally and there was no difference in discard rate between OPO‐Present and OPO‐Absent procurements. Finally, OPO‐Present livers were more likely to be transplanted to pediatric recipients compared to OPO‐Absent (47.3% vs. 24.1% p < .05).ConclusionThe presence of an OPO surgeon has impacted organ utilization, leading to increased transplantation of pediatric livers in pediatric recipients, and has expanded the geographical share of pediatric livers.

Publisher

Wiley

Subject

Transplantation,Pediatrics, Perinatology and Child Health

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