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Updated: Oct 4, 2025
08:12
Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation
Published on: July 15, 2015
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Examining utilization of kidneys as a function of procurement performance.
Brianna L Doby1,2, Katie Ross-Driscoll3, Sharon Yu3
1Positive Rhetoric LLC, Bowling Green, Kentucky, USA.
Summary
Organ procurement organization (OPO) performance varies, impacting deceased donor kidney utilization. Objective OPO metrics can improve organ recovery and transplantation system alignment.
Area of Science:
- Transplantation science
- Organ procurement
- Health services research
Background:
- New metrics for organ procurement organizations (OPOs) are debated, with concerns that low performance may stem from local transplant centers' acceptance of marginal organs.
- Understanding OPO performance and its effect on deceased donor kidney utilization is crucial for optimizing the organ recovery and transplantation system.
Purpose of the Study:
- To explore the relationship between objectively measured OPO performance and the utilization of deceased donor kidneys.
- To investigate how OPO performance differences affect kidney acceptance and discard rates across different donor characteristics.
Main Methods:
- Review of 2013-2019 Organ Procurement and Transplantation Network (OPTN) and National Centers for Health Statistics (NCHS) data.
- Analysis of deceased donor kidney recovery, utilization, and discard rates in relation to OPO performance metrics.
- Comparison of organ acceptance behaviors in donor service areas (DSAs) served by high-performing versus low-performing OPOs.
Main Results:
- Donor kidney recovery declined with increasing donor age and Kidney Donor Profile Index (KDPI), but OPO performance differences persisted within these groups.
- The number of discarded kidneys per donor did not vary significantly with OPO performance.
- Centers in DSAs with lower-performing OPOs exhibited higher local kidney utilization and greater import of high-KDPI kidneys compared to centers with higher-performing OPOs.
Conclusions:
- Objective measures of OPO performance reveal significant variations that influence deceased donor kidney utilization patterns.
- Differences in transplant center acceptance behavior, potentially linked to donor availability relative to waitlist demand, may explain observed utilization disparities.
- Aligning metrics across the entire procurement-transplantation system, including OPO and center-level performance, is essential for improving organ utilization and patient outcomes.
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