Standardized Donor Acceptance Criteria: Impact on Pediatric Waitlist and Heart Transplant Outcomes

Abstract

Purpose Lack of standardization in organ donation acceptance can contribute to an increased donor refusal rate, which may impact waitlist (WL) time, morbidity, mortality and transplant rates. After a review of relevant data, in 9/2017, our center developed and implemented a standardized donor acceptance criteria. We hypothesized that standardization would result in a decrease in WL time and improved WL outcomes. Methods We performed a single center, retrospective analysis of all pediatric ( Results Of 78 listed, 54 were transplanted, 8 removed due to death/clinical deterioration, 16 removed to due clinical improvement. Patient characteristics were similar between the groups (Table 1). Difference in removal from the WL for death or deterioration in Group 2 vs. 1 (n=2, 7% vs. n=6, 17%, p=0.28) did not reach statistical significance. WL time was significantly shorter in Group 2 (17 days, IQR 6-55) vs. Group 1 (90, IQR 13-167; p=0.006). The median DOR was lower in Group 2 (2, IQR 0-3) vs. Group 1 (4, IQR 2-20; p=0.001). The percentage of DOR with LVEF > 55% was lower in Group 2 vs. Group 1 (53% vs. 84%, p=0.001). Post-transplant outcomes were similar between groups (table 1). Conclusion DOR and WL time significantly decreased after a standardized donor acceptance criteria. This analysis supports the need for a standardized approach to donor organ acceptance within a pediatric transplant center.