The Social Structure of Organ Transplantation in the United States

Venugopal, Srividhya; Stoner, Evan; Cadeiras, Martín; Menezes, Ronaldo

doi:10.1007/978-3-642-30287-9_21

Cited by 2 publications

(1 citation statement)

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“…One study constructed a kidney transplant network using U.S. states as nodes and found a combined density of 0.87 in looking at all living and deceased-donor transplants between 1987 and 2010 while ignoring directionality (i.e. differences in whether kidneys were received or sent) (17). Similarly, while our study found much lower densities for each year, if we combined all years and ignored directionality, we found a density of 0.81.…”

Section: Discussionmentioning

confidence: 99%

Association Between Organ Procurement Organization Social Network Centrality and Kidney Discard and Transplant Outcomes

et al. 2015

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Background Given growth in kidney transplant waitlists and discard rates, donor kidney acceptance is an important problem. We used network analysis to examine whether organ procurement organization (OPO) network centrality affects discard and outcomes. Methods We identified 106,160 deceased-donor kidneys recovered for transplant from 2000–2010 in SRTR. We constructed the transplant network by year with each OPO representing a node and each kidney-sharing relationship between OPOs representing a directed tie between nodes. Primary exposures were the number of different OPOs to which an OPO has given a kidney or from which an OPO has received a kidney in year preceding procurement year. Primary outcomes were discard, cold-ischemia time, delayed graft function, and 1-year graft loss. We used multivariable regression, restricting analysis to the 50% of OPOs with highest discard and stratifying remaining OPOs by kidney volume. Models controlled for kidney donor risk index, waitlist time, and kidney pumping. Results An increase in one additional OPO to which a kidney was given by a procuring OPO in a year was associated with 1.4% lower likelihood of discard for a given kidney (odds ratio, 0.986; 95% confidence interval, 0.974-0.998) among OPOs procuring high kidney volume, but 2% higher likelihood of discard (OR:1.021, CI:1.006, 1.037) among OPOs procuring low kidney volume, with mixed associations with recipient outcomes. Conclusions Our study highlights the value of network analysis in revealing how broader kidney sharing is associated with levels of organ acceptance. We conclude interventions to promote broader inter-OPO sharing could be developed to reduce discard for a subset of OPOs.

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Section: Discussionmentioning

confidence: 99%