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VCA Deceased Donors in the United States

Wainright, Jennifer L., PhD1; Wholley, Christopher L.2; Rosendale, John1; Cherikh, Wida S., PhD1; Di Battista, Darren3; Klassen, David K., MD4

doi: 10.1097/TP.0000000000002457
Original Clinical Science—General
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Background. Vascularized composite allograft (VCA) transplants include diverse organ types and are made possible primarily by deceased donors.

Methods. We used Organ Procurement and Transplantation Network data to characterize VCA deceased donors (n = 66 of 70) in the United States from 1998 to 2017 and compare their characteristics with those of kidney donors in 2017.

Results. Through December 31, 2017, 20 transplant programs performed 72 deceased-donor VCA transplants, with organs donated by 70 donors, including 30 upper limb (17 unilateral and 13 bilateral) and 11 face donors. Other donors donated both upper limbs and face (n = 2), uterus (n = 4), abdominal wall (n = 19), larynx (n = 2), penis (n = 1), and scalp (n = 1). About a third of VCA donors were female, and the majority (86.4%) were white. Almost half (45.5%) were between the ages 18 and 34 years. Smaller proportions were younger than 18 years (19.7%), 35 to 44 years (15.2%), 45 to 54 years (13.6%), and older than 55 years (6.1%). Median body mass index for all VCA donors was 24.9 and varied widely, especially for upper limb and face donors. There was considerable variation in Kidney Donor Profile Index among VCA donors (median, 27.5; interquartile range, 11–59). Donor causes of death included head trauma (39.4%), cerebrovascular/stroke (25.8%), and anoxia (31.8%). VCA donors also donated solid organs that were transplanted, including 87.1% of kidneys, 93.9% of livers, 40.2% of lungs, and 56.1% of hearts.

Conclusions. donors are a demographically and clinically diverse group. Understanding this diversity and future trends in VCA donor characteristics is critical in supporting this life-changing field of transplantation.

1 Research Department, United Network for Organ Sharing, Richmond, VA.

2 Policy Department, United Network for Organ Sharing, Richmond, VA.

3 Professional Education, United Network for Organ Sharing, Richmond, VA.

4 United Network for Organ Sharing, Richmond, VA.

Received 18 July 2018. Revision received 29 August 2018.

Accepted 21 September 2018.

J.L.W., C.L.W., J.R., W.S.C., and D.K.K. participated in research design. J.L.W., C.L.W., J.R., D.D.B., W.S.C., and D.K.K. participated in writing of the article. J.L.W. participated in performance of the research. J.L.W. participated in data analysis.

The authors declare no conflicts of interest.

This work was conducted under the auspices of the United Network for Organ Sharing (UNOS), contractor for OPTN, under Contract 234-2005-370011C (US Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation).

Correspondence: Jennifer L. Wainright, PhD, 700 N 4th St, Richmond, VA 23219. (jennifer.wainright@unos.org).

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