title: Resource utilization associated with procurement of transplantable organs from donors that do not meet OPTN eligible death criteria.
abstract: BACKGROUND
  The strategy of evaluating every donation opportunity warrants an investigation into the financial feasibility of this practice. The purpose of this investigation is to measure resource utilization required for procurement of transplantable organs in an organ procurement organization (OPO).
  
  
  METHODS
  Donors were stratified into those that met OPTN-defined eligible death criteria (ED donors, n=589) and those that did not (NED donors, n=703). Variable direct costs and time utilization by OPO staff for organ procurement were measured and amortized per organ transplanted using permutation methods and statistical bootstrapping/resampling approaches.
  
  
  RESULTS
  More organs per donor were procured (3.66±1.2 vs. 2.34±0.8, P<0.0001) and transplanted (3.51±1.2 vs. 2.08±0.8, P<0.0001) in ED donors compared with NED donors. The variable direct costs were significantly lower in the NED donors ($29,879.4±11590.1 vs. $19,019.6±7599.60, P<0.0001). In contrast, the amortized variable direct costs per organ transplanted were significantly higher in the NED donors ($8,414.5±138.29 vs. $9,272.04±344.56, P<0.0001). The ED donors where thoracic organ procurement occurred were 67% more expensive than in abdominal-only organ procurement. The total time allocated per donor was significantly shorter in the NED donors (91.2±44.9 hr vs. 86.8±78.6 hr, P=0.01). In contrast, the amortized time per organ transplanted was significantly longer in the NED donors (23.1±0.8 hr vs. 36.9±3.2 hr, P<0.001).
  
  
  CONCLUSIONS
  The variable direct costs and time allocated per organ transplanted is significantly higher in donors that do not meet the eligible death criteria.
authors: 1 Division of Abdominal Transplant, University of Alabama at Birmingham, Birmingham, AL. 2 School of Public Health-Biostatistics, University of Alabama at Birmingham Birmingham, AL. 3 Preventive Medicine, University of Alabama at Birmingham Birmingham, AL. 4 Alabama Organ Center, Health Services Foundation, Birmingham, Alabama. 5 School of Public Health-Health Care Organization and Policy, University of Alabama at Birmingham Birmingham, AL. 6 Address correspondence to: Derek A. DuBay, M.D., Division of Transplantation University of Alabama at Birmingham ZRB 701, 1530 3rd Ave, S Birmingham, AL 35294-0007.
authors: Derek A
authors: DA
authors: DuBay
authors: David T
authors: DT
authors: Redden
authors: Mary K
authors: MK
authors: Bryant
authors: David P
authors: DP
authors: Dorn
authors: Mona N
authors: MN
authors: Fouad
authors: Stephen H
authors: SH
authors: Gray
authors: Jared A
authors: JA
authors: White
authors: Jayme E
authors: JE
authors: Locke
authors: Christopher B
authors: CB
authors: Meeks
authors: Garry C
authors: GC
authors: Taylor
authors: Meredith L
authors: ML
authors: Kilgore
authors: Devin E
authors: DE
authors: Eckhoff
mesh_terms: D000368:Aged; D001926:Brain Death; D003362:Cost-Benefit Analysis; D003657:Decision Making; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D016377:Organ Transplantation / Q000191:economics / Q000706:statistics & numerical data*; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000458:organization & administration*; D014481:United States