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Kidney Discard Rates in the United States During American Transplant Congress Meetings

Abdelwahab Elhamahmi, Dina, MD, FRCP1; Chaly, Thomas Jr, MD2; Wei, Guo, MS3; Hall, Isaac E., MD, MS3

doi: 10.1097/TXD.0000000000000849
Kidney Transplantation: PDF Only

Background Deceased-donor kidney discard rates vary by region, but it is unknown whether discard rates and transplant outcomes vary during the American Transplant Congress (ATC) each year.

Methods Using national registry data, we determined rates of kidney discard, delayed graft function, graft failure, and mortality from December 31, 1999, through December 30, 2015, during ATC dates and compared these rates with those on the same days of the week during the 2 weeks before and after the ATC (non-ATC). We used multivariable regression to determine associations between ATC and these outcomes.

Results From 7902 donors (1575 ATC; 6327 non-ATC), 12588 recipients received kidney transplants (2455 ATC; 10133 non-ATC), and 2666 kidneys were discarded (582 ATC; 2084 non-ATC). Kidneys were more often discarded during ATC (19% vs 17%, P = 0.006; adjusted odds ratio, 1.21; 95% confidence interval, 1.05-1.40). There were no significant differences in donor, transplant, or recipient characteristics by ATC/non-ATC dates or by ATC/non-ATC transplant dates for delayed graft function, graft failure, or mortality.

Conclusions On the basis of a 21% increased odds of discard, the ATC itself may result in 5 additional kidney discards during this important conference every year, which suggests the need for innovative staffing or other logistic solutions during these planned meetings.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

1 Transplant Center, Mayo Clinic Hospital, Phoenix, AZ.

2 Department of Surgery, Division of Transplantation and Advanced Hepatobiliary Surgery, University of Utah School of Medicine, Salt Lake City, UT.

3 Department of Internal Medicine, Division of Nephrology and Hypertension, University of Utah School of Medicine, Salt Lake City, UT.

Published online 4 December, 2018.

Received 28 August 2018. Revision requested 4 March 2018.

Accepted 17 October 2018.

Portions of this article have been presented as a poster at the 2017 American Transplant Congress meeting, Chicago, Illinois, April 29-May 3, 2017.

Portions of this article have been published in abstract form: Am J Transplant. 2017;17 (suppl 3).

©2017 Mayo Foundation for Medical Education and Research.

The authors declare no funding or conflicts of interest.

D.A. participated in research design, data analysis, writing of the article. T.C. participated in research design, data analysis, and writing of the article. G.W. participated in research design, data analysis, and writing of the article. I.H. participated in research design, data analysis, and writing of the article.

Correspondence: Isaac E. Hall, MD, MS, Department of Internal Medicine, Division of Nephrology and Hypertension, University of Utah School of Medicine, 30 North 1900 East, Salt Lake City, UT 84132. (isaac.hall@hsc.utah.edu).

Supplemental digital content (SDC) is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal’s Web site (www.transplantationdirect.com).

© 2018 The Authors. Published by Wolters Kluwer Health, Inc.