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Title: Risk Indices in Deceased Donor Organ Allocation for Transplantation: Review From an Australian Perspective.
Austin Authors: Ling, Jonathan E H;Fink, Michael A ;Westall, Glen;Macdonald, Peter;Clayton, Philip A;Holdsworth, Rhonda;Opdam, Helen;Polkinghorne, Kevan R;Kanellis, John
Affiliation: General and Hepato-Pancreato-Biliary Surgery, Austin Health, Heidelberg, Victoria, Australia
St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia
Respiratory and Transplant physician, Alfred Hospital, Victoria, Australia
Nephrology Unit, Monash Medical Centre, Victoria, Australia
Organ and Tissue Authority, Australia
Australian Red Cross Blood Service, Transplantation and Immunogenetics Laboratories in Adelaide, Melbourne, and Sydney, Australia
Nephrology Unit, Royal Adelaide Hospital, South Australia, Australia
Issue Date: May-2019
Date: 2019-02-18
Publication information: Transplantation 2019;103(5): 875-889
Abstract: Over the last decade, organ donation and transplantation rates have increased in Australia and worldwide. Donor and recipient characteristics for most organ types have generally broadened resulting in the need to consider more complex data in transplant decision-making. As a result of some of these pressures, the Australian software used for donor and recipient data management is currently being updated. Because of the in-built capacity for improved data management, organ allocation processes will have the opportunity to be significantly reviewed, in particular the possible use of risk indices to guide organ allocation and transplantation decisions. We aimed to review risk indices used in organ allocation policies worldwide and to compare their use to current Australian protocols. Significant donor, recipient and transplant variables in the indices were summarized. We conclude that Australia has the opportunity to incorporate greater use of risk indices in its allocation policies and in transplant decision-making processes. However, while risk indices can assist with organ allocation and help guide prognosis, they often have significant limitations which need to be properly appreciated when deciding how to best use them to guide clinical decisions.
DOI: 10.1097/TP.0000000000002613
Journal: Transplantation
PubMed URL: 30801513
Type: Journal Article
Appears in Collections:Journal articles

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