Import kidney offers and DonorNet: a view from the trenches

Sokolich J, Magliocca J, Kayler LK. Import kidney offers and DonorNet: a view from the trenches.
Clin Transplant 2011: 25: 856–863. © 2010 John Wiley & Sons A/S. Abstract: The ability of DonorNet2007^® screening functions to expedite placement of locally rejected kidneys is unknown. We separately evaluated non‐mandatory share regional (n = 641) and national (n = 720) kidney offers to our center between 5/2007 and 2/2009 for cold ischemia time at offer (oCIT) with respect to candidate ranking to identify donor factors associated with early oCIT and assess the impact of screening functions. oCIT was <7 h after recovery in 83.2% of regional and 34% of national offers. Of national offers, donor characteristics significantly (p < 0.05) associated with oCIT less than median (10 h) were as follows: age <4 yr (vs. 4–35 yr), age >69 yr (vs. 60–69 yr), serum creatinine peak >2.0 and terminal >2.0 mg/dL, and glomerulosclerosis >15% (vs. 0–5%). The trend in early offers was predominantly attributed to greater proportions of pre‐recovery offers. Only one factor, age >69 yr, was significantly associated with proportionately more offers at low sequence numbers. Our data suggest an effect of age within DonorNet^® screening functions to reduce candidate list size and result in earlier offers. Shorter offer oCITs are otherwise occur largely because of pre‐recovery offers from donors with certain types of pre‐recovery characteristics.