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 nonuse rates. Among 57 OPOs between March 2021 and December 2023, we analyzed trends in OOS utilization and its association with kidney nonuse 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 SD (12.8%) of OOS allocation was modestly associated with a reduction in kidney nonuse rates (incidence risk ratio = 0.98; P = .04). Donor characteristics, particularly older age, donation after circulatory death, and high kidney donor profile index, were the strongest predictors of nonuse. While OOS allocation may mitigate logistical challenges, other strategies may be more effective at reducing the nonuse rate.
自2021年以来，无序肾脏分配（OOS）变得越来越普遍。我们研究了器官采购组织（OPO）的OOS分配频率与肾脏不使用率之间的关系。在2021年3月至2023年12月期间的57例opo中，我们分析了OOS利用率的趋势及其与肾脏非使用率的关系。各opo的OOS使用存在显著差异，在整个期间，一些opo分配了超过20%的肾脏。OOS分配绝对增加1个标准差（12.8%）与肾脏不使用率的降低适度相关（IRR 0.98, P = 0.04）。供者特征，特别是年龄较大、循环性死亡后的捐赠和高肾供者概况指数，是不使用肾脏的最强预测因子。虽然OOS分配可能减轻后勤挑战，但其他策略可能更有效地降低不使用率。
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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