Influence of the procurement surgeon on transplanted abdominal organ outcomes

An SRTR analysis to evaluate regional organ procurement collaboration

Research output: Contribution to journalArticle

Abstract

Single-center studies have demonstrated regional organ procurement collaboration to reduce travel redundancy and improve procurement efficiency. We studied deceased donor kidney, liver, and pancreas transplants performed in the United States between 2002 and 2014 using the Scientific Registry of Transplant Recipients (SRTR). We compared graft failure (GF), death-censored graft failure (DCGF), and patient death (PD) between organs procured by surgeons from the recipient's center (transplant procurement team [TPT]) versus surgeons from a different center (NTPT). Primary nonfunction (PNF) was assessed for liver and kidney and delayed graft function (DGF) for kidney using mixed-effects logistic modeling. There were 64 906 liver (61.6% TPT), 118 152 kidney (26.1% TPT), 10 832 simultaneous pancreas kidney (SPK; 56.6% TPT), and 4378 solitary pancreas (SP; 34.0% TPT) transplants. When compared to NTPT, DCGF for organs procured by TPT was significantly less for liver (adjusted HR: 0.93; 95% CI: 0.88-0.98) and marginally significant for kidney (0.97; 0.93-1.00) and SPK (0.90; 0.82-1.00), and not significant for SP (0.98; 0.86 -1.11). DGF for TPT kidney was significantly lower (adjusted OR 0.91; 0.87-0.95). Albeit modest, our findings demonstrate a difference between locally procured organs and those procured by the implanting team. Elucidating the etiology of these differences will enhance regional organ procurement collaboration.

Original languageEnglish (US)
JournalAmerican Journal of Transplantation
DOIs
StatePublished - Jan 1 2019

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Tissue and Organ Procurement
Registries
Transplants
Kidney
Delayed Graft Function
Pancreas
Liver
Surgeons
Transplant Recipients
Tissue Donors

Keywords

  • clinical research/practice
  • delayed graft function (DGF)
  • kidney (allograft) function/dysfunction
  • liver allograft function/dysfunction
  • liver transplantation/hepatology
  • organ procurement
  • organ procurement and allocation
  • pancreas/simultaneous pancreas-kidney transplantation
  • Scientific Registry for Transplant Recipients (SRTR)

Cite this

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title = "Influence of the procurement surgeon on transplanted abdominal organ outcomes: An SRTR analysis to evaluate regional organ procurement collaboration",
abstract = "Single-center studies have demonstrated regional organ procurement collaboration to reduce travel redundancy and improve procurement efficiency. We studied deceased donor kidney, liver, and pancreas transplants performed in the United States between 2002 and 2014 using the Scientific Registry of Transplant Recipients (SRTR). We compared graft failure (GF), death-censored graft failure (DCGF), and patient death (PD) between organs procured by surgeons from the recipient's center (transplant procurement team [TPT]) versus surgeons from a different center (NTPT). Primary nonfunction (PNF) was assessed for liver and kidney and delayed graft function (DGF) for kidney using mixed-effects logistic modeling. There were 64 906 liver (61.6{\%} TPT), 118 152 kidney (26.1{\%} TPT), 10 832 simultaneous pancreas kidney (SPK; 56.6{\%} TPT), and 4378 solitary pancreas (SP; 34.0{\%} TPT) transplants. When compared to NTPT, DCGF for organs procured by TPT was significantly less for liver (adjusted HR: 0.93; 95{\%} CI: 0.88-0.98) and marginally significant for kidney (0.97; 0.93-1.00) and SPK (0.90; 0.82-1.00), and not significant for SP (0.98; 0.86 -1.11). DGF for TPT kidney was significantly lower (adjusted OR 0.91; 0.87-0.95). Albeit modest, our findings demonstrate a difference between locally procured organs and those procured by the implanting team. Elucidating the etiology of these differences will enhance regional organ procurement collaboration.",
keywords = "clinical research/practice, delayed graft function (DGF), kidney (allograft) function/dysfunction, liver allograft function/dysfunction, liver transplantation/hepatology, organ procurement, organ procurement and allocation, pancreas/simultaneous pancreas-kidney transplantation, Scientific Registry for Transplant Recipients (SRTR)",
author = "Serrano, {Oscar K.} and Vock, {David M} and Snyder, {Jon J.} and Srinath Chinnakotla and Raja Kandaswamy and Pruett, {Timothy L} and Matas, {Arthur J} and Finger, {Erik B}",
year = "2019",
month = "1",
day = "1",
doi = "10.1111/ajt.15301",
language = "English (US)",
journal = "American Journal of Transplantation",
issn = "1600-6135",
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TY - JOUR

T1 - Influence of the procurement surgeon on transplanted abdominal organ outcomes

T2 - An SRTR analysis to evaluate regional organ procurement collaboration

AU - Serrano, Oscar K.

AU - Vock, David M

AU - Snyder, Jon J.

AU - Chinnakotla, Srinath

AU - Kandaswamy, Raja

AU - Pruett, Timothy L

AU - Matas, Arthur J

AU - Finger, Erik B

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Single-center studies have demonstrated regional organ procurement collaboration to reduce travel redundancy and improve procurement efficiency. We studied deceased donor kidney, liver, and pancreas transplants performed in the United States between 2002 and 2014 using the Scientific Registry of Transplant Recipients (SRTR). We compared graft failure (GF), death-censored graft failure (DCGF), and patient death (PD) between organs procured by surgeons from the recipient's center (transplant procurement team [TPT]) versus surgeons from a different center (NTPT). Primary nonfunction (PNF) was assessed for liver and kidney and delayed graft function (DGF) for kidney using mixed-effects logistic modeling. There were 64 906 liver (61.6% TPT), 118 152 kidney (26.1% TPT), 10 832 simultaneous pancreas kidney (SPK; 56.6% TPT), and 4378 solitary pancreas (SP; 34.0% TPT) transplants. When compared to NTPT, DCGF for organs procured by TPT was significantly less for liver (adjusted HR: 0.93; 95% CI: 0.88-0.98) and marginally significant for kidney (0.97; 0.93-1.00) and SPK (0.90; 0.82-1.00), and not significant for SP (0.98; 0.86 -1.11). DGF for TPT kidney was significantly lower (adjusted OR 0.91; 0.87-0.95). Albeit modest, our findings demonstrate a difference between locally procured organs and those procured by the implanting team. Elucidating the etiology of these differences will enhance regional organ procurement collaboration.

AB - Single-center studies have demonstrated regional organ procurement collaboration to reduce travel redundancy and improve procurement efficiency. We studied deceased donor kidney, liver, and pancreas transplants performed in the United States between 2002 and 2014 using the Scientific Registry of Transplant Recipients (SRTR). We compared graft failure (GF), death-censored graft failure (DCGF), and patient death (PD) between organs procured by surgeons from the recipient's center (transplant procurement team [TPT]) versus surgeons from a different center (NTPT). Primary nonfunction (PNF) was assessed for liver and kidney and delayed graft function (DGF) for kidney using mixed-effects logistic modeling. There were 64 906 liver (61.6% TPT), 118 152 kidney (26.1% TPT), 10 832 simultaneous pancreas kidney (SPK; 56.6% TPT), and 4378 solitary pancreas (SP; 34.0% TPT) transplants. When compared to NTPT, DCGF for organs procured by TPT was significantly less for liver (adjusted HR: 0.93; 95% CI: 0.88-0.98) and marginally significant for kidney (0.97; 0.93-1.00) and SPK (0.90; 0.82-1.00), and not significant for SP (0.98; 0.86 -1.11). DGF for TPT kidney was significantly lower (adjusted OR 0.91; 0.87-0.95). Albeit modest, our findings demonstrate a difference between locally procured organs and those procured by the implanting team. Elucidating the etiology of these differences will enhance regional organ procurement collaboration.

KW - clinical research/practice

KW - delayed graft function (DGF)

KW - kidney (allograft) function/dysfunction

KW - liver allograft function/dysfunction

KW - liver transplantation/hepatology

KW - organ procurement

KW - organ procurement and allocation

KW - pancreas/simultaneous pancreas-kidney transplantation

KW - Scientific Registry for Transplant Recipients (SRTR)

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U2 - 10.1111/ajt.15301

DO - 10.1111/ajt.15301

M3 - Article

JO - American Journal of Transplantation

JF - American Journal of Transplantation

SN - 1600-6135

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