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Monday blues of deceased-donor liver transplantation
See Ching Chan1, Wing Chiu Dai, Chung Mau Lo
1Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
Insights
Fewer deceased-donor liver transplants occurred on Mondays, indicating potential improvements in organ donation coordination. This study highlights opportunities to increase organ supply and save more lives.
Area of Science:
- Transplantation research
- Organ donation
- Surgical outcomes
Background:
- Global shortage of deceased-donor organs for transplantation.
- Identifying strategies to secure more organs can improve patient outcomes.
- Optimizing organ procurement is crucial for meeting transplant demand.
Purpose of the Study:
- To analyze the weekly distribution of deceased-donor liver transplantations (DDLTs).
- To identify potential disparities in DDLT rates across different days of the week.
- To explore factors influencing organ donation activity.
Main Methods:
- Retrospective analysis of 237 DDLTs performed between January 2000 and December 2009.
- Comparison of DDLT numbers across all days of the week.
- Statistical analysis to determine significant differences in DDLT rates.
Main Results:
- DDLTs were significantly less frequent on Mondays compared to other days (P<0.05).
- Fewer organ donor consents were obtained on Sundays, impacting Monday transplant numbers.
- A consistent weekly trend was observed, unaffected by increased graft availability.
Conclusions:
- Deceased-donor organ donation activities show a significant weekly disparity, with lower rates on Mondays.
- Opportunities exist to enhance organ donation coordination and reduce potential wastage.
- Addressing these disparities could increase the organ supply for patients awaiting transplantation.
Background:
There is a constant and global shortage of deceased-donor organs for transplantation. Ways to identify areas for securing potential deceased-donor organs may improve the supply and hence benefit more patients in need of transplantation.
Methods:
We looked into the disparity of the number of deceased-donor liver transplantation (DDLT) performed at our hospital on different days of the weeks from January 2000 to the end of December 2009 (237 DDLTs). The number of DDLT performed on each day was compared with the other days of the week.
Results:
It was apparent that there were fewer DDLTs on Mondays, as shown by the numbers of DDLT performed on different days of the week in an ascending order: Monday 18 (7.6%), Sunday 30 (12.7%), Thursday 34 (14.3%), Friday 36 (15.2%), Wednesday 38 (16.0%), Tuesday 40 (16.9%), and Saturday 41 (17.3%). The difference reached statistical significance when Monday was compared with Tuesday (P=0.019), Wednesday (P=0.010), Friday (P=0.021), and Saturday (P=0.007). It was twice as unlikely a DDLT would be performed on Monday as compared with other days. Such a trend did not change even with an increase in the number of deceased-donor liver grafts in the last year. As consent to donation was obtained from the donor family the day before DDLT, fewer consents were thus obtained on Sundays.
Conclusion:
These findings suggested that deceased-donor organ donation activities were less active on Sundays and could be improved. This further raises the concern of possible wastage of potential cases of organ donation.
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