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 language | English (US) |
|---|---|
| Pages (from-to) | 2219-2231 |
| Number of pages | 13 |
| Journal | American Journal of Transplantation |
| Volume | 19 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 1 2019 |
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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
Influence of the procurement surgeon on transplanted abdominal organ outcomes : An SRTR analysis to evaluate regional organ procurement collaboration. / Serrano, Oscar; Vock, David M; Snyder, Jon J.; Chinnakotla, Srinath; Kandaswamy, Raja; Pruett, Timothy L; Matas, Arthur J; Finger, Erik B.
In: American Journal of Transplantation, Vol. 19, No. 8, 01.08.2019, p. 2219-2231.Research output: Contribution to journal › Article
}
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
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.
KW - Scientific Registry for Transplant Recipients (SRTR)
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
UR - http://www.scopus.com/inward/record.url?scp=85062954555&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85062954555&partnerID=8YFLogxK
U2 - 10.1111/ajt.15301
DO - 10.1111/ajt.15301
M3 - Article
C2 - 30748093
AN - SCOPUS:85062954555
VL - 19
SP - 2219
EP - 2231
JO - American Journal of Transplantation
JF - American Journal of Transplantation
SN - 1600-6135
IS - 8
ER -