Abstract: TH-PO874
Geographic Proximity to Donor Care Units Among Deceased Organ Donors After Brain Death
Session Information
- Transplantation: Donation and Access
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Vail, Emily Anne, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
- Tam, Vicky, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
- Hasz, Richard, Gift of Life Donor Program, Philadelphia, Pennsylvania, United States
- Abt, Peter, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
- Reese, Peter P., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
- Martin, Niels Douglas, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
- Olthoff, Kim M., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
- Potluri, Vishnu S., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
Background
The National Academies recommend that all United States (US) organ procurement organizations (OPOs) operate deceased donor care units (DCU) but adoption is incomplete. Donors in hospitals at greater distances from DCUs may be less likely to transfer. We sought to characterize the geographic proximity of donors in hospitals to operating DCUs as a proxy for nationwide DCU access.
Methods
Retrospective analysis of all adult deceased donors after brain death with recovery dates Jan 2010 - Jun 2022 in Organ Procurement and Transplantation Network data. Driving times and distances between donor hospitals and DCUs were measured using ArcGIS road network software. We defined geographic proximity to a DCU by estimated driving times; primary outcome was drive time <2 hours (feasible for ground transport). We estimated the number of donors who would gain access to DCUs if OPO donor service area boundaries were ignored.
Results
Among 92 085 donors in 2574 hospitals, 42 302 (42.0%) were managed in one of 25 OPOs with DCUs. Among donors in those areas, a majority (86.7%, 36 687 donors in 999 hospitals) were within 2 hours’ driving distance of a DCU. Rates of DCU proximity varied by OPO (median 43.5% (IQR 0-67.8%) of donors per OPO). When OPO area boundaries were ignored, 8164 additional donors in 229 hospitals were within 2 hours’ distance of at least one DCU (Fig 1). Donor characteristics were similar between groups.
Conclusion
Less than half of donors were within 2 hours drive of a DCU. Proximity rates rates varied across donor service areas. A substantial number of donors were in hospitals proximate to an existing DCU in a neighboring area. OPOs may consider collaborating to transfer donors from hospitals in nearby areas or opening additional DCUs. Future work is needed to understand whether, and how, optimally located DCUs may improve kidney donation and transplantation outcomes.
Distribution of acute-care hospitals in US mainland donor service areas with operating DCUs.
Funding
- Private Foundation Support