PROviding Better ACcess To ORgans: A comprehensive overview of organ-access initiatives from the ASTS PROACTOR Task Force

Hobeika, Mark J.; Miller, Charles M.; Pruett, Timothy L.; Gifford, Kimberly A.; Locke, Jayme E.; Cameron, Andrew M.; Englesbe, Michael J.; Magliocca, Joseph F.; McCune, Kasi; Mekeel, Kristin L.; Pelletier, Shawn J.; Singer, Andrew L.; Segev, Dorry L.

doi:10.1111/ajt.14441

Cited by 8 publications

(8 citation statements)

References 72 publications

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“…[24][25][26] Experts have repeatedly recommended utilizing all deceased donor kidneys that are acceptable for transplantation. 27,28 However, US transplant programs are less likely to use a wider range of deceased donors for transplantation compared to other countries. For instance, estimates suggest that 62% of the kidneys discarded annually in the US would have been transplantable in France based on their characteristics.…”

Section: Discussionmentioning

confidence: 99%

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Hardest-to-place kidney transplant outcomes in the United States

Kayler

Nie

Noyes

2021

American Journal of Transplantation

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A kidney transplant improves quality and quantity of life at reduced costs compared with dialysis, 1,2 yet only 20% of waitlisted individuals are transplanted each year in the United States (US). 3 Concurrently, 20% of all kidneys recovered for transplantation are discarded every year, 4-6 a proportion high above that of the United Kingdom (10%-12%) 7,8 and France (9.1%). 9 Kidney discard in the US is largely related to uncertainty about kidney quality and risk aversion by transplant programs. 6,[10][11][12][13] There is no precise measure of kidney quality, so it is unclear which discarded kidneys would have similar outcomes to accepted kidneys with similar characteristics.Exacerbating uncertainty about donor quality is regulatory scrutiny. Each US transplant program's results are publicly reported

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Section: Discussionmentioning

confidence: 99%

“…Experts have repeatedly recommended utilizing all deceased donor kidneys that are acceptable for transplantation 27,28 . However, US transplant programs are less likely to use a wider range of deceased donors for transplantation compared to other countries.…”

Section: Discussionmentioning

confidence: 99%

Hardest-to-place kidney transplant outcomes in the United States

Kayler

Nie

Noyes

2021

American Journal of Transplantation

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“…4 There is a paucity of data on the effect of a designated OPO procurement surgeon; however, one study from Europe has suggested that professionalization of procurements can lead to more organs available for transplantation and fewer surgical injuries. 5 OPOs have employed other novel methods to change the traditional model of organ procurement, such as utilizing an OPO procurement center, 6 which has been shown to decrease cost and increase organs procured, 7 and also prevent burnout and promote safety in transplantation. 8 The role of the OPO surgeon is not to entirely replace institutional procurement teams but rather to assist in the procurement and placement of organs.…”

Section: Introductionmentioning

confidence: 99%

“…OPOs have employed other novel methods to change the traditional model of organ procurement, such as utilizing an OPO procurement center, 6 which has been shown to decrease cost and increase organs procured, 7 and also prevent burnout and promote safety in transplantation 8 . The role of the OPO surgeon is not to entirely replace institutional procurement teams but rather to assist in the procurement and placement of organs.…”

Section: Introductionmentioning

confidence: 99%

The effect of an organ procurement organization surgeon on pediatric organ utilization

Hwang,

Shubin,

Patel

et al. 2023

Pediatric Transplantation

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IntroductionOrgan procurement organizations (OPO) have started to employ transplant‐trained surgeons dedicated to organ procurement with the aim to increase allograft utilization and enhance the use of procured organs. We investigated the effects of an OPO‐employed surgeon on the procurement and utilization of organs from pediatric donors within the Southwestern Transplant Alliance OPO.MethodsOPO data were obtained for all procurements that were performed between 2014 and 2019. The analysis was performed to see if the presence of an OPO donor surgeon impacted the utilization of pediatric livers. Donor and recipient demographic data were examined between allografts procured with the presence of an OPO surgeon (OPO‐Present) and those without an OPO surgeon (OPO‐Absent). A p‐value of <.05 was considered significant.ResultsOf 149 pediatric procurements, 91 included an OPO‐donor surgeon. In procurements with OPO‐Present, donors were younger (8.2 vs. 11.2, p < .05) and had longer distances to travel to the recipient center (334 vs. 175 miles p < .05), but had comparable cold ischemic times. In terms of organ share type, more OPO‐Present livers were shared nationally and there was no difference in discard rate between OPO‐Present and OPO‐Absent procurements. Finally, OPO‐Present livers were more likely to be transplanted to pediatric recipients compared to OPO‐Absent (47.3% vs. 24.1% p < .05).ConclusionThe presence of an OPO surgeon has impacted organ utilization, leading to increased transplantation of pediatric livers in pediatric recipients, and has expanded the geographical share of pediatric livers.

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“…However, it is undeniable the efforts countries have made to increase the number of donors and to reduce the gap between demand and supply of organs. In the United States, for example, the American Society of Transplant Surgeons (ASTS) envisioned ending organ shortages by increasing post-mortem donations, living donations, and better utilization of organs (Hobeika et al 2017). It is paramount to face ODTSC challenges and it equally important to improve its performance.…”

Section: Introductionmentioning

confidence: 99%

Analysis of the Organ Donation and Transplant Process with Process Mining: Comparing 2021 and 2022 Supply Chain Data in Rio de Janeiro

Paim,

Senna,

Moura

et al. 2023

Proceedings of the International Conference on Industrial Engineering and Operations Management

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The organ donation and transplantation supply chain -ODTSC is a complex and multi-professional system with donors, organs, recipients, and waiting families on the upstream chain side and transplanted patients, and their families, on the supply chain downstream side. Health professionals must coordinate and streamline the donation, transplantation, and transplanted patients' care, as the 3 main processes in the ODTSC. These processes have been improving in several countries, but the global demand for donated organs is nearly 1,3 to 2 million and the transplantation capacity is below 150,000 surgeries. The research was motivated by low performance when comparing Rio de Janeiro data from 2021 and 2022 to benchmarks and its main objective was to improve practices by analyzing the ODTSC and its process and data. Process mining -PM has been evolving from a process and data science topic to a useful technology related to production engineering. In health services, the hospital environment, health production systems, and society benefit from PM utilization with a new way to increase value. Discover the variants, checking the conformance to regulations, analyzing causes, and proposing improvements are PM techniques used to enhance performance and reduce the gap between organ demand and supply. The data was used to analyze the process design, the data itself, and indicators by applying PM techniques and using a tool. The methodology was based on the design research and multiple studies cases methods with a bibliographical review -and no previous work was found, demonstrating the novelty of this research; PM tools selection, data preparation; and interviews to identify improvements. With the study, it was possible to demonstrate the applicability of PM, and an increase of 15 % in organs donated in Rio de Janeiro ODTSC was observed.

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PROviding Better ACcess To ORgans: A comprehensive overview of organ-access initiatives from the ASTS PROACTOR Task Force

Cited by 8 publications

References 72 publications

Hardest-to-place kidney transplant outcomes in the United States

Hardest-to-place kidney transplant outcomes in the United States

The effect of an organ procurement organization surgeon on pediatric organ utilization

Analysis of the Organ Donation and Transplant Process with Process Mining: Comparing 2021 and 2022 Supply Chain Data in Rio de Janeiro

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