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. 2021 Nov;21(11):3758-3764.
doi: 10.1111/ajt.16773. Epub 2021 Aug 9.

Opportunity to increase deceased donation for United States veterans

Brianna L Doby  1 , Diane Brockmeier  2 , Kevin J Lee  2 , Christine Jasien  3 , Julia Gallini  3 , Xiangqin Cui  3 , Rebecca H Zhang  4 , Seth J Karp  5 , Gary Marklin  2 , Raymond J Lynch  3   6
Affiliations

Opportunity to increase deceased donation for United States veterans

Brianna L Doby et al. Am J Transplant. 2021 Nov.

Abstract

Recent changes to organ procurement organization (OPO) performance metrics have highlighted the need to identify opportunities to increase organ donation in the United States. Using data from the Organ Procurement and Transplantation Network (OPTN), Scientific Registry of Transplant Recipients (SRTR), and Veteran Health Administration Informatics and Computing Infrastructure Clinical Data Warehouse (VINCI CDW), we sought to describe historical donation performance at Veteran Administration Medical Centers (VAMCs). We found that over the period 2010-2019, there were only 33 donors recovered from the 115 VAMCs with donor potential nationwide. VA donors had similar age-matched organ transplant yields to non-VA donors. Review of VAMC records showed a total of 8474 decedents with causes of death compatible with donation, of whom 5281 had no infectious or neoplastic comorbidities preclusive to donation. Relative to a single state comparison of adult non-VA inpatient deaths, VAMC deaths were 20 times less likely to be characterized as an eligible death by SRTR. The rate of conversion of inpatient donation-consistent deaths without preclusive comorbidities to actual donors at VAMCs was 5.9% that of adult inpatients at non-VA hospitals. Overall, these findings suggest significant opportunities for growth in donation at VAMCs.

Keywords: clinical research / practice; donors and donation; donors and donation: deceased; health services and outcomes research; organ procurement and allocation.

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Figures

FIGURE 1
FIGURE 1
Comparative breakdown of inpatient deaths and deceased donation, 2010–2019. (A) Veterans Administration Medical Centers, with deaths defined by discharge diagnoses. (B) United States, with donation-consistent deaths defined by death certificate methods
FIGURE 2
FIGURE 2
Pictorial representation of potential donor cohorts and observed donation rates in VA medical centers and the United States overall, 2010–2019. Y-axis depicts percentage of adult potential donor cohort in each age group
See this image and copyright information in PMC

References

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