Changing Metrics of Organ Procurement Organization Performance in Order to Increase Organ Donation Rates in the United States

D. Goldberg, M. J. Kallan, L. Fu, M. Ciccarone, J. Ramirez, P. Rosenberg, J. Arnold, G. Segal, K. P. Moritsugu, H. Nathan, R. Hasz, P. L. Abt

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

The shortage of deceased-donor organs is compounded by donation metrics that fail to account for the total pool of possible donors, leading to ambiguous donor statistics. We sought to assess potential metrics of organ procurement organizations (OPOs) utilizing data from the Nationwide Inpatient Sample (NIS) from 2009–2012 and State Inpatient Databases (SIDs) from 2008–2014. A possible donor was defined as a ventilated inpatient death ≤75 years of age, without multi-organ system failure, sepsis, or cancer, whose cause of death was consistent with organ donation. These estimates were compared to patient-level data from chart review from two large OPOs. Among 2,907,658 inpatient deaths from 2009–2012, 96,028 (3.3%) were a “possible deceased-organ donor.” The two proposed metrics of OPO performance were: (1) donation percentage (percentage of possible deceased-donors who become actual donors; range: 20.0–57.0%); and (2) organs transplanted per possible donor (range: 0.52–1.74). These metrics allow for comparisons of OPO performance and geographic-level donation rates, and identify areas in greatest need of interventions to improve donation rates. We demonstrate that administrative data can be used to identify possible deceased donors in the US and could be a data source for CMS to implement new OPO performance metrics in a standardized fashion.

Original languageEnglish (US)
Pages (from-to)3183-3192
Number of pages10
JournalAmerican Journal of Transplantation
Volume17
Issue number12
DOIs
StatePublished - Dec 2017
Externally publishedYes

Keywords

  • clinical research/practice
  • donors and donation
  • donors and donation: deceased
  • ethics and public policy
  • law/legislation
  • organ procurement
  • organ procurement and allocation
  • organ procurement organization

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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