Landscape of deceased donors labeled increased risk for disease transmission under new guidelines

L. M. Kucirka, M. G. Bowring, A. B. Massie, X. Luo, L. H. Nicholas, D. L. Segev

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

Deceased donors are labeled increased risk for disease transmission (IRD) if they meet certain criteria. New PHS guidelines were recently implemented; the impact of these changes remains unknown. We aimed to quantify the impact of the new guidelines on the proportion of deceased donors labeled IRD, as well as demographic and clinical characteristics. We used Poisson regression with an interaction term for era (new vs. old guidelines) to quantify changes. Under the new guidelines, 19.5% donors were labeled IRD, compared to 10.4%, 12.2%, and 12.3% in the 3 most recent years under the old guidelines (IRR = 1.45, p < 0.001). Increases were consistent across OPOs: 44/59 had an increase in the percent of donors labeled IRD, and 14 OPOs labeled 25% of their donors IRD under the new guidelines (vs. 5 OPOs under the old). African-Americans were 52% more likely to be labeled IRD under the new guidelines (RR = 1.52, p = 0.01). There has been a substantial increase in donors labeled IRD under the new PHS guidelines; it is important to understand the mechanism and consequences to ensure an optimal balance of patient safety and organ utilization is achieved. In this study of national registry data, the percentage of deceased donors labeled CDC Increased Risk for Disease Transmission rose significantly from 12.3% to 19.5% following the implementation of new CDC guidelines in February 2014.

Original languageEnglish (US)
Pages (from-to)3215-3223
Number of pages9
JournalAmerican Journal of Transplantation
Volume15
Issue number12
DOIs
StatePublished - Dec 2015

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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