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. 2019 Oct 17;5(11):e504.
doi: 10.1097/TXD.0000000000000938. eCollection 2019 Nov.

Epidemiology and Comorbidity Burden of Organ Donor Referrals in Australia: Cohort Study 2010-2015

Imogen K Thomson  1 , Brenda M Rosales  1 , Patrick J Kelly  1 , Kate Wyburn  1   2 , Karen M J Waller  1 , Daniel Hirsch  1 , Michael J O'Leary  3   4 , Angela C Webster  1   5
Affiliations

Epidemiology and Comorbidity Burden of Organ Donor Referrals in Australia: Cohort Study 2010-2015

Imogen K Thomson et al. Transplant Direct. .

Abstract

Increasing organ donation rates in Australia have been exceeded by a rise in potential donor referrals not proceeding to donate. Referral evaluation is resource-intensive. We sought to characterize organ donor referrals in New South Wales, Australia, and identify predictors of referrals not proceeding to donation.

Methods: We performed a cohort study of NSW Organ and Tissue Donation Service logs 2010-2015, describing the prevalence and impact of comorbidities on referral outcome. Logistic regression was used to identify comorbidities influencing outcome and predict probability of donation.

Results: Of 2977 referrals, 669 (22%) donated and 2308 (78%) did not. Despite increasing donation rates, the proportion proceeding to donate declined 2010-2015. Among referrals, the prevalence of all comorbidities except cerebrovascular disease increased and was higher among nondonors. History of cardiac disease, ≥65 years of age, chronic kidney or liver disease, malignancy, and absence of cerebrovascular disease were all significantly (P < 0.01) associated with non donation. Hypertension and diabetes did not significantly impact outcome. Predicted probability of donation varied from <1% to 54% depending on comorbidity burden of the referral.

Conclusions: Comorbidity burden among donor referrals is increasing. The presence of particular comorbidities may significantly impact referral outcome. A better understanding of referral characteristics associated with non donation may improve the efficiency of the referral process in the context of encouraging routine referrals.

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Figures

FIGURE 1.
FIGURE 1.
NSW organ donor referral process. DCD, donation after circulatory death; NSW, New South Wales; OTDS, Organ and Tissue Donation Service.
FIGURE 2.
FIGURE 2.
NSW organ donor referrals January 2010–December 2015. Dashed lines are linear trend lines. NSW, New South Wales.
See this image and copyright information in PMC

References

    1. ANZDATA. Australia and New Zealand Organ Donation Registry. 2016 Annual Report. 2016. Available at http://www.anzdata.org.au/anzod/ANZODReport/2016/2016-anzod-full-report-.... Accessed September 15, 2016.
    1. The Transplantation Society of Australia and New Zealand. Organ transplantation from deceased donors: eligibility criteria and allocation protocols: background review. 2014. Available at https://www.anzdata.org.au/report/anzdata-39th-annual-report-2016/. Accessed September 15, 2016.
    1. Saidi RF, Markmann JF, Jabbour N, et al. The faltering solid organ donor pool in the United States (2001-2010). World J Surg 2012362909–2913 - PubMed
    1. Australian Government Organ and Tissue Authority. Best practice guideline for offering organ and tissue donation in Australia. 2017. Available at http://www.donatelife.gov.au/sites/default/files/Best%20practice%20guide.... Accessed September 14, 2017.
    1. United Network for Organ Sharing. A guide to calculating and interpreting the Kidney Donor Profile Index (KDPI). 2019. Available at https://optn.transplant.hrsa.gov/media/1512/guide_to_calculating_interpr.... Accessed September 30, 2016.