Predicting Expected Organ Donor Numbers in Australian Hospitals Outside of the Donate-Life Network Using the Anzics Adult Patient Database.

Abstract

The majority of organ donations in Australia occur in the DonateLife Network of hospitals, but limited monitoring at other sites may allow donation opportunities to be missed. Our aim was to estimate expected donor numbers using routinely collected data from the Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database (APD), and determine whether unrecognised potential donors might exist in non-DonateLife hospitals. All deaths at 150 Australian ICUs contributing to the ANZICS APD were analysed between January 2010 and December 2015. Donor numbers were extracted from the Australian and New Zealand Organ Donor registry. A univariate linear regression model was developed to estimate expected donor numbers in DonateLife hospitals, then applied to non-DonateLife hospitals. Of 33,614 deaths at 71 DonateLife hospitals, 6835 (20%) met criteria as 'ICU deaths potentially suitable to be donors" and 1992 (6%) were actual donors. There was a consistent relationship between these groups (R2=0.626, p<0.001) allowing the development of a prediction model which adequately estimated expected donors. Of 8,077 deaths in 79 non-DonateLife ICUs, 452 (6%) met criteria as potentially suitable donors. Applying the prediction model developed in DonateLife hospitals, the estimated expected donors in non-DonateLife hospitals was 130. However, there were only 75 actual donors. It is possible to estimate the expected number of Australian organ donors using routinely collected registry data. These findings suggest there may be a small but significant pool of under-utilised potential donors in non-DonateLife hospitals. This may provide an opportunity to increase donation rates.