title: Donor risk indices in pancreas allocation in the Eurotransplant region.
abstract: Pancreas donor selection and recognition are important to cope with increasing organ shortage. We aim to show that the PDRI is more useful than the P-PASS to predict acceptance and should thus be preferred over P-PASS. Eurotransplant donors from 2004 until 2014 were included in this study. PDRI logistical factors were set to reference to purely reflect donor quality (PDRI donor ). PDRI and P-PASS association with allocation outcome was studied using area under the receiver operating characteristic curve (AUROC). Regional differences in donor quality were also investigated. Of the 10 444 pancreata that were reported, 6090 (58.3%) were accepted and 2947 (28.2%) were transplanted. We found that P-PASS was inferior to PDRIdonor in its ability to predict organ reporting, acceptance, and transplantation: AUC 0.63, 0.67 and 0.73 for P-PASS vs. 0.78, 0.79 and 0.84 for PDRIdonor , respectively. Furthermore, there were significant differences in donor quality among different Eurotransplant countries, both in reported donors and in transplanted organs. PDRI is a powerful predictor of allocation outcome and should be preferred over P-PASS. Proper donor selection and recognition, and possibly a more liberal approach toward inferior quality donors, may increase donation and transplant rates.
authors.affiliation: Eurotransplant International Foundation, Leiden, The Netherlands.|Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Wouter H
authors.initials: WH
authors.lastname: Kopp
authors.affiliation: Eurotransplant International Foundation, Leiden, The Netherlands.
authors.forename: Erwin
authors.initials: E
authors.lastname: de Vries
authors.affiliation: Eurotransplant International Foundation, Leiden, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: de Boer
authors.affiliation: Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Hein
authors.initials: H
authors.lastname: Putter
authors.affiliation: University Hospital Rostock, Rostock, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Schareck
authors.affiliation: Eurotransplant International Foundation, Leiden, The Netherlands.
authors.forename: Undine
authors.initials: U
authors.lastname: Samuel
authors.affiliation: Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Andries E
authors.initials: AE
authors.lastname: Braat
mesh_terms: D000328:Adult; D019540:Area Under Curve; D046148:Donor Selection; D005060:Europe; D005260:Female; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000379:methods*; D010182:Pancreatic Diseases / Q000601:surgery*; D012372:ROC Curve; D012306:Risk; D012307:Risk Factors; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods*; D016896:Treatment Outcome
keywords: donation; donor identification; expanded donor pool; pancreas clinical; selection criteria