Transplant International (Jun 2024)

Ten Years of Quality Monitoring of Abdominal Organ Procurement in the Netherlands and Its Impact on Transplant Outcome

  • K. A. Chotkan,
  • K. A. Chotkan,
  • I. P. J. Alwayn,
  • I. P. J. Alwayn,
  • A. C. Hemke,
  • A. Baranski,
  • A. Baranski,
  • W. Nijboer,
  • W. Nijboer,
  • R. A. Pol,
  • A. E. Braat,
  • A. E. Braat

DOI
https://doi.org/10.3389/ti.2024.12989
Journal volume & issue
Vol. 37

Abstract

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In this study, 10 years of procurement quality monitoring data were analyzed to identify potential risk factors associated with procurement-related injury and their association with long-term graft survival. All deceased kidney, liver, and pancreas donors from 2012 to 2022 and their corresponding recipients in the Netherlands were retrospectively included. The incidence of procurement-related injuries and potential risk factors were analyzed. Of all abdominal organs procured, 23% exhibited procurement-related injuries, with a discard rate of 4.0%. In kidneys and livers, 23% of the grafts had procurement-related injury, with 2.5% and 4% of organs with procurement-related injury being discarded, respectively. In pancreas procurement, this was 27%, with a discard rate of 24%. Male donor gender and donor BMI >25 were significant risk factors for procurement-related injury in all three abdominal organs, whereas aberrant vascularization was significant only for the kidney and liver. In the multivariable Cox regression analyses, procurement-related injury was not a significant predictor for graft failure (kidney; HR 0.99, 95% CI 0.75–1.33, p = 0.99, liver; HR 0.92, 95% CI 0.66–1.28, p = 0.61, pancreas: HR 1.16; 95% CI 0.16–8.68, p = 0.88). The findings of this study suggest that transplant surgeons exhibited good decision-making skills in determining the acceptability and repairability of procurement-related injuries.

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