Donor risk indices in pancreas allocation in the Eurotransplant region
| Autor: | Erwin de Vries, Undine Samuel, Hein Putter, Wouter H. Kopp, Andries E. Braat, Wolfgang Schareck, Jan de Boer |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Risk medicine.medical_specialty Tissue and Organ Procurement Economic shortage pancreas clinical 030230 surgery Donor Selection 03 medical and health sciences 0302 clinical medicine Risk Factors medicine donor identification Humans Transplantation Receiver operating characteristic business.industry Donor selection Graft Survival donation Pancreatic Diseases Middle Aged expanded donor pool Tissue Donors Surgery Europe Treatment Outcome ROC Curve Transplanted Organs Donation Area Under Curve Emergency medicine 030211 gastroenterology & hepatology Female Pancreas Transplantation business Regional differences selection criteria |
| Zdroj: | Transplant International, 29(8), 921-929 |
| ISSN: | 1432-2277 |
| Popis: | Summary Pancreas donor selection and recognition are important to cope with increasing organ shortage. We aim to show that the PDRI is more useful than the P-PASS to predict acceptance and should thus be preferred over P-PASS. Eurotransplant donors from 2004 until 2014 were included in this study. PDRI logistical factors were set to reference to purely reflect donor quality (PDRI donor). PDRI and P-PASS association with allocation outcome was studied using area under the receiver operating characteristic curve (AUROC). Regional differences in donor quality were also investigated. Of the 10 444 pancreata that were reported, 6090 (58.3%) were accepted and 2947 (28.2%) were transplanted. We found that P-PASS was inferior to PDRIdonor in its ability to predict organ reporting, acceptance, and transplantation: AUC 0.63, 0.67 and 0.73 for P-PASS vs. 0.78, 0.79 and 0.84 for PDRIdonor, respectively. Furthermore, there were significant differences in donor quality among different Eurotransplant countries, both in reported donors and in transplanted organs. PDRI is a powerful predictor of allocation outcome and should be preferred over P-PASS. Proper donor selection and recognition, and possibly a more liberal approach toward inferior quality donors, may increase donation and transplant rates. |
| Databáze: | OpenAIRE |
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