2019
Hedley, James A.; Chang, Nicholas; Kelly, Patrick J.; Rosales, Brenda M.; Wyburn, Kate; O'Leary, Michael; Cavazzoni, Elena; Webster, Angela C.
Weekend effect: analysing temporal trends in solid organ donation Journal Article
In: ANZ Journal of Surgery, vol. 89, no. 9, pp. 1068–1074, 2019, ISSN: 1445-2197.
Abstract | Links | BibTeX | Tags: ORCHARD
@article{Hedley2019,
title = {Weekend effect: analysing temporal trends in solid organ donation},
author = {James A. Hedley and Nicholas Chang and Patrick J. Kelly and Brenda M. Rosales and Kate Wyburn and Michael O'Leary and Elena Cavazzoni and Angela C. Webster},
doi = {10.1111/ans.15015},
issn = {1445-2197},
year = {2019},
date = {2019-09-00},
urldate = {2019-09-00},
journal = {ANZ Journal of Surgery},
volume = {89},
number = {9},
pages = {1068--1074},
publisher = {Wiley},
abstract = {<jats:sec><jats:title>Background</jats:title><jats:p>Research suggests patients treated over weekends experience poorer outcomes. Only one US‐based study explored this weekend effect in organ donation, specifically the kidney discard rate. In Australia potential donors are referred to a donation service, and donation proceeds if family consent is granted and the donor is deemed medically suitable to donate. Organ procurement occurs when utilization is almost certain hence discard rates are much lower than in the USA. We aimed to characterize the effect of weekend referral on organ donation in Australia.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We retrospectively reviewed all New South Wales Organ and Tissue Donation Service logs from 2010 to 2016. Our primary outcome was progression to organ procurement, and secondary outcomes were family consent and meeting medical suitability thresholds. We used logistic regression with random effects adjusting for clustering of referral hospitals.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Of 3496 potential donors referred for consideration, 694 (20%) progressed to organ procurement. There were fewer referrals on weekends (average 415 versus 588 for weekdays). However, donation rates were no lower for weekend compared to weekday referrals (adjusted OR 1.17; 95% CI 0.95, 1.44). Family consent (adjusted OR 1.20; 95% CI 1.00, 1.44) and medical suitability (adjusted OR 1.15; 95% CI 0.96, 1.38) were not lower for weekend compared to weekday referrals. Similar results were found for all sensitivity analyses conducted.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>In Australia, the donation pathway operates consistently throughout the week, with donation no less likely to proceed on weekends and holidays. This finding contrasts with findings in the USA.</jats:p></jats:sec>},
keywords = {ORCHARD},
pubstate = {published},
tppubtype = {article}
}
<jats:sec><jats:title>Background</jats:title><jats:p>Research suggests patients treated over weekends experience poorer outcomes. Only one US‐based study explored this weekend effect in organ donation, specifically the kidney discard rate. In Australia potential donors are referred to a donation service, and donation proceeds if family consent is granted and the donor is deemed medically suitable to donate. Organ procurement occurs when utilization is almost certain hence discard rates are much lower than in the USA. We aimed to characterize the effect of weekend referral on organ donation in Australia.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We retrospectively reviewed all New South Wales Organ and Tissue Donation Service logs from 2010 to 2016. Our primary outcome was progression to organ procurement, and secondary outcomes were family consent and meeting medical suitability thresholds. We used logistic regression with random effects adjusting for clustering of referral hospitals.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Of 3496 potential donors referred for consideration, 694 (20%) progressed to organ procurement. There were fewer referrals on weekends (average 415 versus 588 for weekdays). However, donation rates were no lower for weekend compared to weekday referrals (adjusted OR 1.17; 95% CI 0.95, 1.44). Family consent (adjusted OR 1.20; 95% CI 1.00, 1.44) and medical suitability (adjusted OR 1.15; 95% CI 0.96, 1.38) were not lower for weekend compared to weekday referrals. Similar results were found for all sensitivity analyses conducted.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>In Australia, the donation pathway operates consistently throughout the week, with donation no less likely to proceed on weekends and holidays. This finding contrasts with findings in the USA.</jats:p></jats:sec>
Thomson, Imogen K.; Rosales, Brenda M.; Kelly, Patrick J.; Wyburn, Kate; Waller, Karen M. J.; Hirsch, Daniel; O’Leary, Michael J.; Webster, Angela C.
Epidemiology and Comorbidity Burden of Organ Donor Referrals in Australia: Cohort Study 2010–2015 Journal Article
In: vol. 5, no. 11, 2019, ISSN: 2373-8731.
Abstract | Links | BibTeX | Tags: ORCHARD
@article{Thomson2019,
title = {Epidemiology and Comorbidity Burden of Organ Donor Referrals in Australia: Cohort Study 2010–2015},
author = {Imogen K. Thomson and Brenda M. Rosales and Patrick J. Kelly and Kate Wyburn and Karen M.J. Waller and Daniel Hirsch and Michael J. O’Leary and Angela C. Webster},
doi = {10.1097/txd.0000000000000938},
issn = {2373-8731},
year = {2019},
date = {2019-00-00},
urldate = {2019-00-00},
volume = {5},
number = {11},
publisher = {Ovid Technologies (Wolters Kluwer Health)},
abstract = {Increasing organ donation rates in Australia have been exceeded by a rise in potential donor referrals not proceeding to donate. Referral evaluation is resource-intensive. We sought to characterize organ donor referrals in New South Wales, Australia, and identify predictors of referrals not proceeding to donation.
We performed a cohort study of NSW Organ and Tissue Donation Service logs 2010–2015, describing the prevalence and impact of comorbidities on referral outcome. Logistic regression was used to identify comorbidities influencing outcome and predict probability of donation.
Of 2977 referrals, 669 (22%) donated and 2308 (78%) did not. Despite increasing donation rates, the proportion proceeding to donate declined 2010–2015. Among referrals, the prevalence of all comorbidities except cerebrovascular disease increased and was higher among nondonors. History of cardiac disease, ≥65 years of age, chronic kidney or liver disease, malignancy, and absence of cerebrovascular disease were all significantly (P< 0.01) associated with non donation. Hypertension and diabetes did not significantly impact outcome. Predicted probability of donation varied from <1% to 54% depending on comorbidity burden of the referral.
Comorbidity burden among donor referrals is increasing. The presence of particular comorbidities may significantly impact referral outcome. A better understanding of referral characteristics associated with non donation may improve the efficiency of the referral process in the context of encouraging routine referrals.},
keywords = {ORCHARD},
pubstate = {published},
tppubtype = {article}
}
Increasing organ donation rates in Australia have been exceeded by a rise in potential donor referrals not proceeding to donate. Referral evaluation is resource-intensive. We sought to characterize organ donor referrals in New South Wales, Australia, and identify predictors of referrals not proceeding to donation.
We performed a cohort study of NSW Organ and Tissue Donation Service logs 2010–2015, describing the prevalence and impact of comorbidities on referral outcome. Logistic regression was used to identify comorbidities influencing outcome and predict probability of donation.
Of 2977 referrals, 669 (22%) donated and 2308 (78%) did not. Despite increasing donation rates, the proportion proceeding to donate declined 2010–2015. Among referrals, the prevalence of all comorbidities except cerebrovascular disease increased and was higher among nondonors. History of cardiac disease, ≥65 years of age, chronic kidney or liver disease, malignancy, and absence of cerebrovascular disease were all significantly (P< 0.01) associated with non donation. Hypertension and diabetes did not significantly impact outcome. Predicted probability of donation varied from <1% to 54% depending on comorbidity burden of the referral.
Comorbidity burden among donor referrals is increasing. The presence of particular comorbidities may significantly impact referral outcome. A better understanding of referral characteristics associated with non donation may improve the efficiency of the referral process in the context of encouraging routine referrals.
We performed a cohort study of NSW Organ and Tissue Donation Service logs 2010–2015, describing the prevalence and impact of comorbidities on referral outcome. Logistic regression was used to identify comorbidities influencing outcome and predict probability of donation.
Of 2977 referrals, 669 (22%) donated and 2308 (78%) did not. Despite increasing donation rates, the proportion proceeding to donate declined 2010–2015. Among referrals, the prevalence of all comorbidities except cerebrovascular disease increased and was higher among nondonors. History of cardiac disease, ≥65 years of age, chronic kidney or liver disease, malignancy, and absence of cerebrovascular disease were all significantly (P< 0.01) associated with non donation. Hypertension and diabetes did not significantly impact outcome. Predicted probability of donation varied from <1% to 54% depending on comorbidity burden of the referral.
Comorbidity burden among donor referrals is increasing. The presence of particular comorbidities may significantly impact referral outcome. A better understanding of referral characteristics associated with non donation may improve the efficiency of the referral process in the context of encouraging routine referrals.
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