Funding Sources: The Scientific Registry of Transplant Recipients is funded by contract number 234–2005-37009C from the Health Resources and Services Administration, U.S. Department of Health and Human Services. The views expressed herein are those of the authors and not necessarily those of the U.S. Government.
Efficient Utilization of the Expanded Criteria Donor (ECD) Deceased Donor Kidney Pool: An Analysis of the Effect of Labeling
Version of Record online: 6 JAN 2010
© 2010 The Authors Journal compilation © 2010 The American Society of Transplantation and the American Society of Transplant Surgeons
American Journal of Transplantation
Volume 10, Issue 2, pages 304–309, February 2010
How to Cite
Hirth, R. A., Pan, Q., Schaubel, D. E. and Merion, R. M. (2010), Efficient Utilization of the Expanded Criteria Donor (ECD) Deceased Donor Kidney Pool: An Analysis of the Effect of Labeling. American Journal of Transplantation, 10: 304–309. doi: 10.1111/j.1600-6143.2009.02937.x
Human Subjects Statement: This study was approved by HRSA's SRTR project officer. HRSA has determined that this study satisfies the criteria for the IRB exemption described in the ‘Public Benefit and Service Program’ provisions of 45 CFR 46.101(b)(5) and HRSA Circular 03.
- Issue online: 24 JAN 2010
- Version of Record online: 6 JAN 2010
- Received 14 April 2009, revised 14 September 2009 and accepted for publication 02 October 2009
- Expanded criteria donors;
- kidney transplantation;
We investigated the effect of the expanded criteria donor (ECD) label on (i) recovery of kidneys and (ii) acceptance for transplantation given recovery. An ECD is age ≥ 60, or age 50–59 with ≥ 2 of 3 specified comorbidities. Using data from the Scientific Registry of Transplant Recipients from 1999 to 2005, we modeled recovery rates through linear regression and transplantation probabilities via logistic regression, focusing on organs from donors just-younger versus just-older than the ECD age thresholds. We split the sample at July 1, 2002 to determine how decisions changed at the approximate time of implementation of the ECD definition. Before July 2002, the number of recovered kidneys with 0–1 comorbidities dropped at age 60, but transplantation probabilities given recovery did not. After July 2002, the number of recovered kidneys with 0–1 comorbidities rose at age 60, but transplantation probabilities contingent on recovery declined. No similar trends were observed at donor age 50 among donors with ≥ 2 comorbidities. Overall, implementation of the ECD definition coincided with a reversal of an apparent reluctance to recover kidneys from donors over age 59, but increased selectiveness on the part of surgeons/centers with respect to these kidneys.