(1164) - Expanding the Donor Pool: Regional and Age Variation in Pediatric Organ Donation Rates

Abstract

A shortage of donor organs remains the major limitation to solid organ transplantation, exposing transplant candidates to morbidity and mortality during prolonged wait times. There are limited published data on pediatric organ donation rates. The aim of this study was to assess the variability in organ donation rates across different UNOS regions and pediatric age groups. The OPTN database was queried for all pediatric deceased donors between 1999 and 2013. Donors were stratified by age group and UNOS region. The number of donors per UNOS region was weighted using regional mortality data obtained from the National Center for Health Statistics over the same time period, and donation rates were compared across UNOS regions using chi square tests. There is significant variation in the rate of organ donation based on both age group and UNOS region. The median number of donors per 1000 deaths was lowest in the infant population vs. all other age groups (p<0.001) (Fig. 1). For all age groups, there is significant variation in the rates of organ donation across UNOS regions (p<0.001 for all comparisons). Using the region with the highest donation rate for each age group as the gold standard, we estimate a potential 22% increase in the number of donors if all regions performed comparably, equating to 269 new pediatric donors annually. There is significant regional variation in pediatric organ donation rates. Expansion of the donor pool may be possible by optimizing donation in regions demonstrating lower recruitment of pediatric donors. Infants demonstrate a significantly lower rate of organ donation vs. older children. This finding may be impacted by cause of death in this population and the challenges of declaring brain death in infants. Infant donation rates may also be amenable to targeted improvement strategies.