Centers for Disease Control 'high-risk' donors and kidney utilization

Area of Science:

• Nephrology
• Transplantation Medicine
• Public Health

Background:

• Organ donor risk stratification impacts kidney utilization and transplant outcomes.
• Centers for Disease Control high-risk (CDCHR) designation is applied to certain organ donors.
• Understanding the implications of CDCHR status is crucial for optimizing kidney allocation.

Purpose of the Study:

• To evaluate the effect of CDCHR status on kidney utilization rates.
• To determine if CDCHR status influences kidney transplant recipient survival.
• To assess the potential wastage of standard criteria donor (SCD) kidneys due to CDCHR labeling.

Main Methods:

• Analysis of 45,112 SCD deceased donor kidneys from the Scientific Registry of Transplant Recipients (2005-2009).
• Logistic regression used to compare utilization rates between CDCHR and non-CDCHR kidneys.
• Cox regression analyzed posttransplant survival in 25,158 recipients of SCD kidneys (2005-2008).

Main Results:

• CDCHR kidneys were 8.2% less likely to be utilized for transplantation.
• Adjusted analysis showed CDCHR status was associated with a significantly lower odds ratio of utilization (0.67).
• Recipient survival was similar between CDCHR and non-CDCHR kidney recipients after a median 2-year follow-up (HR 1.06).

Conclusions:

• The 'high-risk' designation for organ donors may lead to the underutilization of otherwise viable SCD kidneys.
• CDCHR status does not appear to adversely affect long-term kidney transplant recipient survival.
• Re-evaluation of organ acceptance criteria for CDCHR donors could potentially increase kidney utilization and save lives.