title: Import kidney offers and DonorNet: a view from the trenches.
abstract: The ability of DonorNet2007(®) screening functions to expedite placement of locally rejected kidneys is unknown. We separately evaluated non-mandatory share regional (n = 641) and national (n = 720) kidney offers to our center between 5/2007 and 2/2009 for cold ischemia time at offer (oCIT) with respect to candidate ranking to identify donor factors associated with early oCIT and assess the impact of screening functions. oCIT was <7 h after recovery in 83.2% of regional and 34% of national offers. Of national offers, donor characteristics significantly (p < 0.05) associated with oCIT less than median (10 h) were as follows: age <4 yr (vs. 4-35 yr), age >69 yr (vs. 60-69 yr), serum creatinine peak >2.0 and terminal >2.0 mg/dL, and glomerulosclerosis >15% (vs. 0-5%). The trend in early offers was predominantly attributed to greater proportions of pre-recovery offers. Only one factor, age >69 yr, was significantly associated with proportionately more offers at low sequence numbers. Our data suggest an effect of age within DonorNet(®) screening functions to reduce candidate list size and result in earlier offers. Shorter offer oCITs are otherwise occur largely because of pre-recovery offers from donors with certain types of pre-recovery characteristics.
authors.affiliation: Shands Hospital at the University of Florida, Gainesville, FL 32610, USA.
authors.forename: Julio
authors.initials: J
authors.lastname: Sokolich
authors.forename: Joseph
authors.initials: J
authors.lastname: Magliocca
authors.forename: Liise K
authors.initials: LK
authors.lastname: Kayler
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D050377:Cold Ischemia; D051799:Delayed Graft Function; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D040841:Resource Allocation; D015996:Survival Rate; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult