NEW research suggests that an integrated approach to deceased donor and kidney transplant services could significantly enhance the utilisation of deceased donor kidneys. Lachlan McMichael, University of British Columbia, Vancouver, Canada, and colleagues, aimed to evaluate the impact of specific policies and practices on the performance of the opt-in deceased donor kidney transplant system in British Columbia between 2016–2019.
The retrospective observational study analysed data from 1,948 referrals, of which 754 were potential donors. Overall, 78% of potential donors consented to donation, with 82% deemed eligible. Ultimately, 91% of eligible donors proceeded with donation, resulting in 99% utilisation of the 438 donated kidneys. The study also found a 1-year all-cause allograft survival rate of 95%.
Various protocols implemented at provincial, organ procurement organisation, and centre levels were identified as contributing factors to these positive outcomes. These included the presence of hospital donor co-ordinators, early communication between procurement organisations and transplant nephrologists, dedicated organ recovery and implant surgeons, age-based kidney allocation, and hospital admission of recipients prior to kidney recovery.
The researchers emphasised the significance of an integrated approach, highlighting the exceptionally high rates of consent for donation, utilisation of donated kidneys, and transplant survival in British Columbia. They suggest that these findings should stimulate further discussion on optimal strategies to integrate deceased donor and transplant services, aiming to enhance system-wide improvements in other regions.
