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)
Pages (from-to)2219-2231
Number of pages13
JournalAmerican Journal of Transplantation
Volume19
Issue number8
DOIs
StatePublished - Aug 1 2019

Fingerprint

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

Keywords

  • Scientific Registry for Transplant Recipients (SRTR)
  • 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

PubMed: MeSH publication types

  • Journal Article

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 = "Scientific Registry for Transplant Recipients (SRTR), 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",
author = "Oscar Serrano 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",
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T1 - Influence of the procurement surgeon on transplanted abdominal organ outcomes

T2 - An SRTR analysis to evaluate regional organ procurement collaboration

AU - Serrano, Oscar

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 - 2019/8/1

Y1 - 2019/8/1

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.

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KW - delayed graft function (DGF)

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KW - liver allograft function/dysfunction

KW - liver transplantation/hepatology

KW - organ procurement

KW - organ procurement and allocation

KW - pancreas/simultaneous pancreas-kidney transplantation

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DO - 10.1111/ajt.15301

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JF - American Journal of Transplantation

SN - 1600-6135

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