Donor organs may be discarded due to 'weekend effect' at hospitals

Deceased donor kidneys are increasingly being discarded, and efforts to boost their use for transplantation are needed. A new study indicates that organs are more likely to be discarded on weekends than on weekdays. The findings, which will be presented at ASN Kidney Week 2015 November 3-8 at the San Diego Convention Center in San Diego, CA, indicate that efforts to save organs procured on weekends may help address the kidney shortage.

For their study, Sumit Mohan, MD (Columbia University) and his colleagues examined information from the Scientific Registry of Transplant Recipients, identifying and comparing all deceased donor kidneys procured on Friday to Saturday with those that were procured on other days of the week.

The investigators found that kidneys that would normally be made available for transplantation were less likely to be procured from donors over the weekend (89.5% on the weekend vs. 90.2% during the week). Organs procured during the weekend were also 20% more likely to be discarded than kidneys procured on other days, and those that were discarded were of higher quality than those discarded during the rest of the week. Organs procured on the weekend were more likely to transplanted at large transplant centers.

"The day of the week when a donor kidney becomes available appears to impact the likelihood of procurement and its subsequent utilization, if procured," said Dr. Mohan. "Deceased donor kidneys that would normally be transplanted over the weekend are less likely to be procured and if procured appear less likely to be transplanted even after adjusting for the quality of the kidney." He noted that weekends are typically associated with fewer available resources, which likely impacts kidney transplantation. Larger centers tend to have more resources available and the ability to continue to perform transplantation over the weekends more easily than smaller centers. "Recognition of the impact of factors beyond organ quality on the procurement and transplantation of deceased donor organs should influence future policy aimed at improving kidney transplantation rates in the United States," said Dr. Mohan.