title: Abdominal organ procurement in the Netherlands - an analysis of quality and clinical impact.
abstract: Between March 2012 and August 2013, 591 quality forms were filled out for abdominal organs in the Netherlands. In 133 cases (23%), there was a discrepancy between the evaluation from the procuring and transplanting surgeons. Injuries were seen in 148 (25%) organs of which 12 (2%) led to discarding of the organ: one of 133 (0.8%) livers, five of 38 (13%) pancreata and six of 420 (1.4%) kidneys (P < 0.001). Higher donor BMI was a risk factor for procurement-related injury in all organs (OR: 1.06, P = 0.011) and donor after cardiac death (DCD) donation in liver procurement (OR: 2.31, P = 0.034). DCD donation is also associated with more pancreata being discarded due to injury (OR: 10.333, P = 0.046). A higher procurement volume in a centre was associated with less injury in pancreata (OR = -0.95, P = 0.013) and kidneys (OR = -0.91, P = 0.012). The quality form system efficiently monitors the quality of organ procurement. Although there is a relatively high rate of organ injury, the discard rate is low and it does not significantly affect 1-year graft survival for any organ. We identified higher BMI as a risk factor for injury in abdominal organs and DCD as a risk factor in livers. A higher procurement volume is associated with fewer injuries.
authors.affiliation: Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.|Dutch Transplant Foundation, Leiden, The Netherlands.
authors.forename: Jacob D
authors.initials: JD
authors.lastname: de Boer
authors.affiliation: Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Wouter H
authors.initials: WH
authors.lastname: Kopp
authors.affiliation: Dutch Transplant Foundation, Leiden, The Netherlands.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Ooms
authors.affiliation: Dutch Transplant Foundation, Leiden, The Netherlands.
authors.forename: Bernadette J
authors.initials: BJ
authors.lastname: Haase-Kromwijk
authors.affiliation: Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Christina
authors.initials: C
authors.lastname: Krikke
authors.affiliation: Department of Surgery, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Jeroen
authors.initials: J
authors.lastname: de Jonge
authors.affiliation: Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: L W Ernst
authors.initials: LW
authors.lastname: van Heurn
authors.affiliation: Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Andre G
authors.initials: AG
authors.lastname: Baranski
authors.affiliation: Department of Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: J Adam
authors.initials: JA
authors.lastname: van der Vliet
authors.affiliation: Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Andries E
authors.initials: AE
authors.lastname: Braat
mesh_terms: D046148:Donor Selection / Q000379:methods / Q000592:standards; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008297:Male; D009426:Netherlands; D016035:Pancreas Transplantation; D011446:Prospective Studies; D012307:Risk Factors; D020858:Tissue and Organ Harvesting / Q000379:methods* / Q000592:standards; D009927:Tissue and Organ Procurement / Q000379:methods* / Q000592:standards
keywords: complications; organ donation; organ procurement; quality