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. 2024 Jun;24(6):983-992.
doi: 10.1016/j.ajt.2024.02.007. Epub 2024 Feb 10.

Characterizing proximity and transfers of deceased organ donors to donor care units in the United States

Emily A Vail  1 , Vicky W Tam  2 , Elizabeth M Sonnenberg  3 , Nikhil R Lavu  4 , Peter P Reese  5 , Peter L Abt  3 , Niels D Martin  3 , Richard D Hasz  6 , Kim M Olthoff  3 , Meeta P Kerlin  7 , Jason D Christie  7 , Mark D Neuman  8 , Vishnu S Potluri  5
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Characterizing proximity and transfers of deceased organ donors to donor care units in the United States

Emily A Vail et al. Am J Transplant. 2024 Jun.

Abstract

Some United States organ procurement organizations transfer deceased organ donors to donor care units (DCUs) for recovery procedures. We used Organ Procurement and Transplantation Network data, from April 2017 to June 2021, to describe the proximity of adult deceased donors after brain death to DCUs and understand the impact of donor service area (DSA) boundaries on transfer efficiency. Among 19 109 donors (56.1% of the cohort) in 25 DSAs with DCUs, a majority (14 593 [76.4%]) were in hospitals within a 2-hour drive. In areas with DCUs detectable in the study data set, a minority of donors (3582 of 11 532 [31.1%]) were transferred to a DCU; transfer rates varied between DSAs (median, 27.7%, range, 4.0%-96.5%). Median hospital-to-DCU driving times were not meaningfully shorter among transferred donors (50 vs 51 minutes for not transferred, P < .001). When DSA boundaries were ignored, 3241 cohort donors (9.5%) without current DCU access were managed in hospitals within 2 hours of a DCU and thus potentially eligible for transfer. In summary, approximately half of United States deceased donors after brain death are managed in hospitals in DSAs with a DCU. Transfer of donors between DSAs may increase DCU utilization and improve system efficiency.

Keywords: donor care unit; health care policy; organ donation; organ transplantation.

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Conflict of interest statement

Declaration of competing interest The authors of this manuscript have conflicts of interest to disclose, as described by the American Journal of Transplantation. Emily Vail, Vicky Tam, and Vishnu Potluri acknowledge investigator-initiated grant support to their institutions from the Transplant Foundation, which supported the current work. Emily Vail acknowledges sponsor-initiated support to her institution from eGenesis, which is unrelated to the current work. She also serves on the Editorial Board of the British Journal of Anaesthesia Open. Niels Martin is Medical Director of the Gift of Life Donor Program at Penn Medicine donor care unit (Philadelphia, PA), which operates under contract from the Gift of Life Donor Program organ procurement organization. Peter Abt is an Associate Editor of the American Journal of Transplantation. Peter Reese acknowledges investigator-initiated grant support to his institution from Merck, Gilead, and eGenesis, all unrelated to the current work. He is also an Associate Editor of the American Journal of Kidney Diseases.

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