Opportunity to increase deceased donation for United States veterans. Issue 11 (9th August 2021)

• Record Type: Journal Article
• Authors: Doby, Brianna L.; Brockmeier, Diane; Lee, Kevin J.; Jasien, Christine; Gallini, Julia; Cui, Xiangqin; Zhang, Rebecca H.; Karp, Seth J.; Marklin, Gary; Lynch, Raymond J.
• Is Part Of: American journal of transplantation. Volume 21:Issue 11(2021)
• Page Start: 3758
• Page End: 3764
• Publication Date: 2021-08-09
• Subjects: clinical research / practice -- donors and donation -- donors and donation: deceased -- health services and outcomes research -- organ procurement and allocation; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.16773
• Languages: English
• ISSNs: 1600-6135

Abstract

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. Abstract : The authors document low rates of identification and recovery of deceased donors at Veterans Administration Medical Centers in the United States.