Organ Donation And Transplantation Research Articles

Organ Donation and Transplantation Registries Across the Globe: A Review of the Current State.

The current landscape of organ donation and transplantation (ODT) registries is not well established. This narrative review sought to identify and characterize the coverage, structure, and data capture of ODT registries globally. We conducted a literature search using Ovid Medline and web searches to identify ODT registries from 2000 to 2023. A list of ODT registries was compiled based on publications of registry design, studies, and reports. Extracted data elements included operational features of registries and the types of donor and recipient data captured. We identified 129 registries encompassing patients from all continents except Antarctica. Most registries were active, received funding from government or professional societies, were national in scope, included both adult and pediatric patients, and reported patient-level data. Registries included kidney (n = 99), pancreas (n = 32), liver (n = 44), heart (n = 35), lung (n = 30), intestine (n = 15), and islet cell (n = 5) transplants. Most registries captured donor data (including living versus deceased) and recipient features (including demographics, cause of organ failure, and posttransplant outcomes) but there was underreporting of other domains (eg, donor comorbidities, deceased donor referral rates, waitlist statistics). This review highlights existing ODT registries globally and serves as a call for increased visibility and transparency in data management and reporting practices. We propose that standards for ODT registries, a common data model, and technical platforms for collaboration, will enable a high-functioning global ODT system responsive to the needs of transplant candidates, recipients, and donors.

Attitudes of Polish Medical Students toward Organ Donation in Cases of Brain Death.

(1) The aim of our study was to determine the attitudes of medical students toward organ donation in the case of brain death. (2) The study was conducted among 1348 medical students from three medical universities in Poland. The research tool was the Polish version of the standardized questionnaire concerning attitudes toward organ donation and transplantation (ODT) [PCID-DTO RIOS: A questionnaire designed by the 'International Collaborative Organ Donation project about organ transplantation and donation]. (3) Some sources of information on organ donation were found to have a significant impact on the recipients' knowledge of brain death. These were books, friends, family, lectures in other centers, social media, and the Church. Medical students holding the opinion that recovery and leading a normal lifestyle after brain death is impossible were significantly more likely to donate their organs after death, not for religious reasons and not because they wanted to survive their own death. (4) The medical students in our study showed a high level of awareness and favorable attitudes toward ODT. However, the number of registered donors was low. It is important to educate students on these issues to raise the awareness of both future medical professionals and the public on organ transplantation procedures. The public should be made aware that transplantation procedures are of a high standard, and that the law protects both donors and recipients. These measures would reduce recipients' waiting time, and certainly increase the statistics of the number of life-saving and health-saving procedures.

The experiences of patients, caregiversand donors on transplant journeys in Canada: A convergent parallel mixed methods study.

The organ donation and transplantation (ODT) system in Canada is complex and can be challenging for individuals to navigate. We thus aimed to illuminate the experiences of individuals on transplant journeys using a patient-oriented convergent parallel mixed-methods approach. We captured data on adult patients, living donors, and caregivers on transplant journeys across Canada through an online survey (n = 935) and focus groups (n = 21). The survey was comprised of 48 questions about the individuals'experiences with the living donation and transplantation system, which were analyzed descriptively. Qualitative data were analyzed using an inductive conventional content analysis approach. Most participants were female (70.1%), English speaking (92.6%)and White (87.8%). Participants'experiences were represented across six key themes: holistic person-centred care, accountable care, collective impact, navigating uncertainty, connectionand advocacy. Quantitative and qualitative data were integrated to identify five opportunities to improve the organ donation and transplantation system in Canada: enhancing mental health support, establishing formal peer support programmes, improving continuity of care, improving knowledge acquisition, and expanding resources and support. It is imperative that the ODT system commits to asking, listening, and learning from individuals on transplant journeys and to provide them opportunities to help improve it.

Mapping trust relationships in organ donation and transplantation: a conceptual model

The organ donation and transplantation (ODT) system heavily relies on the willingness of individuals to donate their organs. While it is widely believed that public trust plays a crucial role in shaping donation rates, the empirical support for this assumption remains limited. In order to bridge this knowledge gap, this article takes a foundational approach by elucidating the concept of trust within the context of ODT. By examining the stakeholders involved, identifying influential factors, and mapping the intricate trust relationships among trustors, trustees, and objects of trust, we aim to provide a comprehensive understanding of trust dynamics in ODT. We employ maps and graphs to illustrate the functioning of these trust relationships, enabling a visual representation of the complex interactions within the ODT system. Through this conceptual groundwork, we pave the way for future empirical research to investigate the link between trust and organ donation rates, informed by a clarified understanding of trust in ODT. This study can also provide valuable insights to inform interventions and policies aimed at enhancing organ donation rates.

Psychosocial Profile of the Attitude Toward Family Organ Donation in People Older Than 65 Years

The population over 65 years of age is key in the decision to donate organs in its different aspects. We sought to analyze the attitude toward organ donation from a relative among people over 65 years of age and to determine the psychosocial variables that may influence their attitude. The study population consisted of citizens over 65 years of age. A representative sample was obtained in southeastern Spain (N=420). A questionnaire about attitudes toward organ donation and transplantation (ODT) was used. Several psycho-social variables were also taken into account. Statistical analysis included the χ2 test and multivariate analysis. The completion rate was 84% (n=351). The favorable attitude toward organ donation from a relative was 53% (n=184). The univariate analysis showed the influence of information variables, conversations on the subject with family and friends, meeting a donor, acceptance of cremation and autopsy, not being afraid of scars after donation, and carrying out prosocial activities (P < .05). In the multivariate analysis, the desire to carry out activities related to the ODT (odds ratio [OR] 2.06) and the favorable opinion of the partner (OR 3.72) persisted. The attitude of older people toward organ donation from a relative is unfavorable. This attitude is influenced by various factors, including dialogue with family and friends and the fact that the partner has a favorable opinion regarding this issue. It is important to carry out training activities on ODT in this group in order not to have a negative impact on organ donation rates in the coming years.

212.3: Developing a modernized Canadian organ donation and transplantation (ODT) data and reporting system.

212.3: Developing a modernized Canadian organ donation and transplantation (ODT) data and reporting system.

Attitude of the Older Population Toward Controlled Asystole Donation

Studies about the knowledge of and attitude toward new lines of organ donation in a group of older people are important due to the increase in older organ donors. To analyze the attitude of citizens over 65 years of age in southeastern Spain toward controlled asystole donation (CAD) and to determine the psycho-social profile that influences this attitude. The study population consisted of citizens over 65 years of age. A representative sample was obtained in southeastern Spain (N=420). A questionnaire about attitudes toward CAD was used, detailing in the questionnaire that this is a type of donation from people who have died of circulatory and respiratory criteria after the limitation of life support treatment. Several psychosocial variables were also taken into account. Statistical analysis included the χ2 test and multivariate analysis. The completion rate was 84% (n=351). Favorable attitude toward organ donation and transplantation (ODT) was 98% (n=344) overall, and CAD was viewed favorably by 45% (n=158). The psychosocial variables that influenced attitude toward CAD were mainly having received a talk about ODT (odds ratio [OR] 5.6), knowing the opinion of one's partner (OR 7.95), acceptance of cremation (OR 1.09), and acceptance of autopsy (OR 3.002). The attitude of older people toward CAD is unfavorable despite a willingness to support ODT in general. This attitude is influenced by variables of social and family dialogue about ODT, attitude to body manipulation, and having received information about ODT.

Inequities in Organ Donation and Transplantation Among Immigrant Populations in Italy: A Narrative Review of Evidence, Gaps in Research and Potential Areas for Intervention.

Immigrants from outside Europe have increased over the past two decades, especially in Southern European countries including Italy. This influx coincided with an increased number of immigrants with end-stage organ diseases. In this narrative review, we reviewed evidence of the gaps between native-born and immigrant populations in the Organ Donation and Transplantation (ODT) process in Italy. Consistent with prior studies, despite the availability of a publicly funded health system with universal healthcare coverage, non-European-born individuals living in Italy are less likely to receive living donor kidney transplantation and more likely to have inferior long-term kidney graft function compared with EU-born and Eastern European-born individuals. While these patients are increasingly represented among transplant recipients (especially kidney and liver transplants), refusal rates for organ donation are higher in some ethnic groups compared with native-born and other foreign-born referents, with the potential downstream effects of prolonged waiting times and inferior transplant outcomes. In the process, we identified gaps in relevant research and biases in existing studies. Given the Italian National Transplant Center's (CNT) commitment to fighting inequities in ODT, we illustrated actions taken by CNT to tackle inequities in ODT among immigrant communities in Italy.

Taking a "Care Pathway/Whole Systems" Approach to Equality Diversity Inclusion (EDI) in Organ Donation and Transplantation in Relation to the Needs of "Ethnic/Racial/Migrant" Minority Communities: A Statement and a Call for Action.

International evidence shows variation in organ donation and transplantation (ODT) based upon a range of patient characteristics. What is less well understood is the impact of patient "ethnicity/race/immigration background," as these terms are defined and intended differently across countries. We also know that these characteristics do not operate in isolation but intersect with a range of factors. In this paper, we propose a framework that seeks to clarify the definition of the key terms "ethnicity/race/migrant" and to review how these communities are operationalized across European studies about inequities in ODT. Further, patients and the public wish to see Equality Diversity Inclusion (EDI) approaches in their everyday lives, not just in relation to ODT. We propose a 'care pathway/whole-systems' approach to ODT encompassing culturally competent public health interventions for a) the prevention and management of chronic diseases, b) improvements in public engagement for the promotion of the culture of ODT and enhancements in end-of-life care, through to c) enhanced likelihood of successful transplant among migrant/ethnic minority communities. Our framework recognizes that if we truly wish to take an EDI approach to ODT, we need to adopt a more social, human and holistic approach to examining questions around patient ethnicity.

Updates in Kidney Transplantation From the 2022 Banff-Canadian Society of Transplantation Joint Meeting: Conference Report.

The 2022 Banff-Canadian Society of Transplantation Meeting in Banff, Alberta, brought together transplant professionals to review new developments across various aspects of solid organ transplantation (SOT) in Canada. Presentations included consensus recommendations from expert-led forums; experiences with new procedures and legislation; reports from public health data repositories; original clinical and laboratory research; and industry updates regarding novel technologies. Speakers referenced articles and reports published in peer-reviewed journals and online, and unpublished data and preliminary findings. All authors attended presentations in-person or virtually. Recordings of select presentations were available for later review. Summaries emphasize concepts indicated by speakers as new and clinically relevant. The COVID-19 pandemic disproportionately affected solid organ transplant recipients (SOTRs), who experience worse outcomes of COVID-19 infection than the general population. Vaccinations demonstrate an attenuated immunological response in SOTRs yet provide meaningful protection. Monoclonal antibodies are effective for both passive immunization and treatment of COVID-19 in SOTRs. Infection control protocols have driven the development of virtual methods for clinical research, such as using home blood draws and virtual follow-up to evaluate vaccine efficacy in SOTRs; and patient care delivery, such as employing telerehabilitation post transplant. Access to living kidney donation is limited by various disincentives experienced by potential donors, which may be overcome by more efficient evaluations including a One-Day Living Kidney Donor Assessment Clinic. The International Donation and Transplantation Legislative and Policy Forum provided a means of establishing consensus guidance for organ donation and transplantation (ODT) program policy to standardize delivery across jurisdictions. The implementation of a deemed consent model for organ and tissue donation in Nova Scotia may provide insight as to whether this model indeed improves access to organs. Canada's Indigenous population experiences unique barriers to transplantation, prompting efforts for more inclusive ODT policy-making. The Pan-Canadian ODT Data and Performance Reporting System Project has defined performance quality indicators, of which iTransplant and other point-of-care software solutions may facilitate collection; however, these endeavors ultimately require information technology infrastructure that exceeds the capabilities of the existing Canadian Organ Replacement Register and Canadian Transplant Registry. Pig-to-human xenotransplantation requires genetic modification of pigs and xenoantibody testing in recipients but may yet prove viable. Serum cell-free DNA, urine biomarkers, and genetic markers offer an alternative to routine biopsy for identifying subclinical rejection. Modified perfusion temperatures and perfusion solutions with hydrogen sulfide donor compounds may improve organ preservation. Molecular compatibility tools provide another means of improving SOTR outcomes, and the Genome Canada Transplant Consortium has been examining important considerations of their implementation. We were unable to capture all presentations and topics at the meeting due to the sizable quantity and variety. Topics ultimately excluded from this summary include those in pathology including Banff Classification updates; those unique to extra-renal SOT; as well as numerous abstract and poster presentations, allied health provider forums, and business meetings. A portion of the material was presented by speakers prior to peer-review or publication. The various conference presentations summarized in this report identify methods by which individual clinicians and provincial ODT programs may improve access, delivery, and quality of SOT care in Canada, while additionally identifying gaps in the literature that investigators are encouraged to pursue.

The Effect of Educational Initiatives on the Attitude and Knowledge of Health Care Professionals Regarding Organ Donation and Transplantation: An Integrative Literature Review

This integrative literature review synthesizes evidence on the effect of educational initiatives (EI) on the attitude and knowledge of health care professionals regarding organ donation and transplantation (ODT), and the EI effect considering the risks of the ODT process related to the professionals' attitudes and knowledge. This search included 8 databases, with search terms across 4 groups: ODT activities, health professionals, attitude/knowledge, and EI. We applied the PICO framework to select articles: Population - health care professionals; Intervention - any EI; Comparison - pre/post or intervention/control designs; and Outcomes - indicators of attitudes or knowledge toward ODT. After the appraisal of 2,221 citations, 21 studies were included in this review. The EI varied to a great extent in terms of format (seminars, workshops, video lectures; online or in-person training), duration (from 15 minutes to 3 months), and the number of participants (from 12 to 1011). The effects reported were positive, increasing professionals' knowledge and attitude regarding the ODT process for all EI formats. Most articles (14; 67%) presented positive results with statistical significance for all indicators analyzed, and the remaining studies (7; 35%) reported statistical significance for some of the indicators analyzed. All EIs focused on donation or post-transplantation activities, lacking studies on the transplantation stage. Results suggest that different types of EIs may positively affect the attitude and knowledge of health care professionals regarding the ODT process. This study provides an up-to-date overview of the main themes examined in this literature, highlighting critical knowledge gaps and methodological flaws.

The New Age of Organ Donation-What Factors Have an Influence on the Attitude of Older People? An Attitudinal Survey in Southeastern Spain.

Currently, more than half of all donors are aged over 65 years, and previous studies have shown that this group is less willing to support organ donation. Objective: to analyse the attitude of people aged over 65 years toward organ donation and transplantation (ODT) and to determine how their psychosocial profile affects their attitude. Study population: citizens residing in southeastern Spain older than 65 years of age. A representative sample was obtained, which was stratified by gender and geographical location (n = 420). A validated questionnaire about ODT was used. Statistical analysis: a bivariate analysis was performed using the X2 test and a multivariate analysis. The favourable attitude toward the donation of one’s own organs was 53%. The psychosocial variables affecting attitude were mainly: having discussed ODT with one’s family (p < 0.001) or friends (OR 2.223), acceptance of cremation (OR 2.508), and acceptance of an autopsy (OR 2.578). Citizens aged over 65 tend to have an unfavourable attitude toward the donation of their own organs. The lack of dialogue about ODT in social and family settings, and the attitude to the manipulation of one’s own body after death, are aspects of a respondent’s psychosocial profile, which influence this attitude.

Challenges facing Indigenous transplant patients living in Canada: exploring equity and utility in organ transplantation decision-making

ABSTRACT Indigenous peoples in Canada and in the Circumpolar North face a higher disease burden leading to end-stage organ failure and face geographic and systemic barriers to accessing health-care services, including those for end-stage organ failure and organ donation and transplantation (ODT). To address these issues, I present a think tank model used in Saskatchewan, Canada, which focused on ODT and recommended research and policy changes that address inequitable Indigenous access to ODT, most specifically in northern and remote regions. Over the past three years, think tank members, comprised of Indigenous cultural leaders, elders, and persons with lived experience in ODT, and complemented by medical and advocacy exports, have highlighted equity and utility issues as key concerns, and discussed ways in which these issues can be addressed. Recommendations include culturally-safe methods for documenting and tracking Indigenous identity, development of training to address culturally specific needs, and additionalfunding to support Indigenous transplant donors and recipients.

Perceptions and Barriers to Deceased Organ Donation in Armenia: A Qualitative Research

Background and aim: Transplantation is the treatment of choice for end-stage organ failure. The worldwide shortageof organs focuses the attention of scientific community and policymakers on it. Despite having a favourable legislativeframework Armenia still do not perform transplantation from deceased donors. Aim of this study is to understandperceptions and barriers of deceased organ donation in Armenia.Methods: This qualitative study utilizes semi-structured, in-depth interviews to produce rich descriptions of healthyadult individuals and main stakeholders about the perceived drivers and barriers to deceased organ donation andtransplantation in Armenia. Participants included healthcare providers, policymaker, priest and healthy adult individualsof other occupation. Content analysis with deductive approach was utilized.Results: 11 in-depth interviews were performed. The main concepts around which the themes evolved were knowledge,attitudes, interaction with health system, family, cultural, religious and socioeconomic factors. Several factors emergedduring the interviews: lack of knowledge, medical distrust, role of the donor’s family as a buffer and misinterpretation ofreligious stance are examples.Conclusion: Lack of knowledge regarding the brain death and deep mistrust to healthcare system were identified as themajor barriers to acceptance of donation after death. It is recommended to conduct a comprehensive educational andawareness raising campaign both for public and providers.

Film Creation for Education on Concepts Related to Religion, Immigration, and Legislation in the Field of Organ Donation and Transplantation

In education, we can use cinema to create methodologies that develop the critical thinking to acquire knowledge in a collaborative way. Favorable attitudes toward organ donation and transplantation (ODT) is low in adolescents. Working on topics related to ODT, such as religion, immigration, and the law, can help to improve students' knowledge and endear them toward ODT with innovative educational methodologies. This study aims to analyze the change in knowledge about religion, immigration, and legislation on ODT after an educational proposal based on film creation. In this study, 16-year-old students participated in an educational proposal based on ODT education through filmmaking. A total of 543 students participated in the experimental group, and 320 participated in the control group. A validated ODT knowledge form was administered to both groups. Statistical analysis was carried out with SPSS version 21.0 package (SPSS, Inc, Chicago, IL, USA). A descriptive analysis and χ2 test were performed to analyze the differences between the experimental group and control group. P < .05 was considered statistically significant. The study had a 72% participation rate in the experimental group. After receiving the educational proposal, the students presented a greater knowledge with respect to the control group in all aspects: the position of the different religions in relation to organ donation, knowledge of the rights and obligations of immigrants in relation to the ODT, and knowledge of the law of presumed consent in ODT CONCLUSIONS: Working in the classroom on psychosocial aspects such as religion, immigration, and legislation through filmmaking can favorably influence the adolescent's awareness of organ donation.

The Audiovisual Creation in Educational Proposals on Organ Donation: Attitude Towards Organ Donation and Transplantation of Secondary School Teachers

Audiovisual creation allows teachers and students to become consumers and producers of information, creating collaborative environments. In the field of organ donation and transplantation (ODT), most of the educational proposals analyzed to date consist of presentations. The teacher does not usually have a decisive role in this type of methodologies, in addition to not having the appropriate training to be able to participate actively. To analyze the change in teachers' attitudes towards ODT after participating in an educational proposal based on the creation of short films. Teachers of secondary education in ten schools in southeastern Spain. The proposal consisted in the creation of short films based on topics related to ODT by the students. A validated ODT attitude form was administered to teachers at the beginning of the proposal and at the end of the proposal. A descriptive analysis was carried out together with McNemar test was used to compare the pre and post test results of the teacher. P < .05 was considered statiscally significant. The favorable attitude towards organ donation at death increased after the proposal (64% vs 88%; P = .008). Favorable attitude towards organ donation from a relative also improved (52% vs 76%; P = .008), as did favorable attitude towards living kidney donation (52% vs 88%; P < .001), living liver donation (36% vs 85%; P = .008) and xenotransplantation (45% vs 82%; P < .001). The teachers improves after an educational proposal based on the creation of short films related to ODT.

The impact of information and communications technology and broadcasting on YouTube for improving attitude toward organ donation in secondary education with the creation of short films

ObjectiveThere is a lack of awareness about organ donation among teenagers, a fact that could decrease future donation rates. The objective is to analyze the impact of an educational proposal based on the creation of short films. MethodsFifteen schools were randomly selected: ten for the experimental group (EG), and five for the control group (CG). In both groups all students from the selected classes participated (EG: n = 543, CG: n = 320).An intervention was undertaken in the EG, providing a website to make a short film about organ donation and transplantation (ODT) to be broadcast on YouTube. The students completed a questionnaire before and after the proposal. StatisticsMann-Whitney test was conducted to compare the pre-test data, McNemar test compare the pre and post test results of each group, and Chi-square test to compare the change in responses between the two groups. ResultsThe change to a more favorable response was greater in the EG in all variables. The YouTube channel received 104,912 viewings. ConclusionsAn innovative educational intervention has a positive influence on teenage attitude and knowledge about ODT; it also has important social repercussions. Practice ImplicationsImplementing this educational proposal about ODT could help improve future donation rates.

Summary of International Recommendations for Donation and Transplantation Programs During the Coronavirus Disease Pandemic.

The COVID-19 pandemic has disrupted all aspects of the international organ donation and transplantation (ODT) system. Multiple organizations have developed guidance, but to date, no comparative summary has emerged to understand differences in existing recommendations. We developed and applied a comparative methodology to a convenience sample of recommendations available on The Transplantation Society website. Document types were classified according to characteristics such as type of organization (eg, governing body or professional society) and geographic region. Recommendations were grouped according to content, and summaries were posted on a public website. This process is ongoing and will be updated as new recommendations become available. Eighteen documents were extracted in the initial review. All documents were based on expert opinion, and none described a formal literature review or adherence with clinical guideline development processes. Recommendation categories included screening of potential donors, risk assessment of potential recipients, posttransplant risk, living/paired donation, protection of ODT professionals, and ethics/logistics. While many documents included similar recommendations, such as the need to screen and test patients who are potential donors, there was variation on some topics. Type of recommended laboratory testing varied with 64% recommending nasopharyngeal swabs, 43% oropharyngeal, and 24% bronchial aspirates. Updated results are available at https://cdtrp.ca/en/covid-19-international-recommendations-for-odt/. The current state of COVID-19 ODT recommendations is limited to expert opinion. Substantial variation exists regarding recommendations, which are based on emerging but currently low-quality evidence. This summary of existing recommendations will serve to inform priorities for evidence-based recommendations.

Regional Report on Organ Transplantation in Trinidad and Tobago.

Regional Report on Organ Transplantation in Trinidad and Tobago.

THE RELATIONSHIP BETWEEN DONOR EGFR AND ALLOGRAFT SURVIVAL IN PAEDIATRIC RENAL TRANSPLANT RECIPIENTS

Introduction: Renal transplantation is the gold standard treatment for end-stage kidney disease in children. The study of prognostic factors which influence renal allograft survival is important to optimise individual patient outcomes and guide decisions regarding allograft allocation. This study tested the null hypothesis that donor eGFR is not associated with renal allograft survival in the deceased donor paediatric renal transplant population in the United Kingdom. Methods: A twenty-year, historical cohort analysis of all paediatric (under 18 years of age), single kidney, deceased donor transplant procedures performed in the United Kingdom. The data was sourced from the UK Organ Donation and Transplantation (ODT) registry by the National Health Service Blood and Transplant (NHSBT) between 1 Jan 1999 and 31 Dec 2019. Donor estimated glomerular filtration rate (eGFR) was presented as a three-level ordered categorical variable, consisting >90, 60 - 90 and <60mls/min/1.73m2 (Groups 1, 2 and 3 respectively). Outcome was death-censored renal allograft survival, defined as the time in days from transplantation to either pre-emptive retransplantation or the initiation of renal replacement therapy. Children with functioning renal transplantation at last follow-up were censored from the analysis. The time to renal allograft failure was analysed with Kaplan Meier survival method and the Cox proportional hazards model used to calculate multivariable hazard ratios for renal allograft failure in relation to increasing eGFR status. Results and Discussion: 1,296 paediatric renal transplant recipients (60% male) with median recipient age of 12 years (range: 0 - 17) at transplantation were transplanted with 64.9% (841), 24.6% (319) and 10.5% (136) having donor eGFR in Groups 1, 2 and 3 respectively. Ten-year renal allograft survival proportion in Groups 1, 2 and 3 respectively were 68.5% (95%CI 64.8 - 72.3%), 66.9% (95%CI 61 - 73.3%) and 64.6 (95%CI 55.6 - 75.2%; Kaplan Meier analysis in Figure 1).A multivariable Cox regression model was fitted to 397 observations of renal allograft failure. Data were consistent with the null hypothesis of no association between increasing donor eGFR status and renal allograft survival, after adjustment for donor/recipient sex and age, HLA A/B/DR mismatch, and donor diabetes mellitus/hypertension status (Figure 2). There was no evidence for important effect modification between donor eGFR and hazard of renal allograft failure with respect to donor hypertension or diabetes status.Conclusion: Data from this study are consistent with the null hypothesis of no association between donor eGFR and renal allograft survival in paediatric renal transplant recipient with the caveat that usually the aim is to use the best organs for children. Nevertheless, further prospective studies in different settings with larger sample sizes are required to confirm this conclusion. This project was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at Great Ormond Street Hospital for Children NHS Foundation Trust and University College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.