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Crossing national borders for transplantation: A focused evaluation of deceased donor lung exports from the United States.

Author information

Affiliations

  • 1. Division of Transplant Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA; Colorado Center for Transplantation Care (CCTCARE), Research and Education, Division of Transplant Surgery, Department of Surgery, Anschutz Medical Campus, University of Colorado, Aurora, Colorado, USA.
      Authors
    • Lopez R 1
    • Arrigain S 1
    • Brosi D 1
    • Kaplan B 1
    • Pomfret EA 1
    (5 authors)
  • 2. Division of Nephrology, Department of Medicine, Vagelos College of Physicians and Surgeons, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA; Division of Nephrology, Columbia University Renal Epidemiology Group, New York, New York, USA.
      Authors
    • Mohan S 2
    • Husain SA 2
    • Yu M 2
    (3 authors)
  • 3. Division of Cardiothoracic Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
      Authors
    • Hoffman JRH 3
    (1 author)
  • 4. Department of Thoracic and Cardiovascular Surgery, Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
      Authors
    • McCurry KR 4
    (1 author)
  • 5. Division of Transplant Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA; Colorado Center for Transplantation Care (CCTCARE), Research and Education, Division of Transplant Surgery, Department of Surgery, Anschutz Medical Campus, University of Colorado, Aurora, Colorado, USA; Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
      Authors
    • Schold JD 5
    (1 author)

ORCIDs linked to this article

Show all (9)

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 28 Aug 2024, :S1600-6135(24)00534-3
https://doi.org/10.1016/j.ajt.2024.08.025 PMID: 39209156 

Abstract 

Organ transplantation is a life-saving treatment for end-stage organ failure patients, but the United States (US) faces a shortage of available organs. US policies incentivize identifying recipients for all recovered organs. Technological advancements have extended donor organ viability, creating new opportunities for long-distance transport and international sharing. We aimed to assess organ exports from deceased US donors to candidates abroad, a component of allocation policy allowed without suitable domestic candidates. Based on the national Scientific Registry of Transplant Recipients data from January 2014 to September 2023, 388 342 organs were recovered for transplantation, with 511 (0.13%) exported. Most exported organs were lungs (80%). Exported lung donors were older (41 vs 34 years, P < .001), more likely hepatitis C positive (22% vs 4%, P < .001), and more likely donors after circulatory death (20% vs 7%, P < .001). Lungs that were eventually exported were offered to more US potential transplant recipients (median = 65) than those kept in the US (median = 21 and 41 for lungs recovered by nonexporting and exporting organ procurement organizations, respectively; P < .001). Our study highlights the necessity for further research and clear policy initiatives to balance the benefits of cross-border sharing while considering potential opportunities for more aggressive organ allocation within the US.

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Read article at publisher's site: https://doi.org/10.1016/j.ajt.2024.08.025

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