{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T10:18:00Z","timestamp":1791886680001,"version":"4.3.4"},"reference-count":21,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Surg"],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"<jats:sec id=\"ab-soi220115-4\"><jats:title>Importance<\/jats:title><jats:p>Availability of organs inadequately addresses the need of patients waiting for a transplant.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi220115-5\"><jats:title>Objective<\/jats:title><jats:p>To estimate the true number of donor patients in the United States and identify inefficiencies in the donation process as a way to guide system improvement.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi220115-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>A retrospective cross-sectional analysis was performed of organ donation across 13 different hospitals in 2 donor service areas covered by 2 organ procurement organizations (OPOs) in 2017 and 2018 to compare donor potential to actual donors. More than 2000 complete medical records for decedents were reviewed as a sample of nearly 9000 deaths. Data were analyzed from January 1, 2017, to December 31, 2018.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi220115-7\"><jats:title>Exposure<\/jats:title><jats:p>Deaths of causes consistent with donation according to medical record review, ventilated patient referrals, center acceptance practices, and actual deceased donors.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi220115-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Potential donors by medical record review vs actual donors and OPO performance at specific hospitals.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi220115-9\"><jats:title>Results<\/jats:title><jats:p>Compared with 242 actual donors, 931 potential donors were identified at these hospitals. This suggests a deceased donor potential of 3.85 times (95% CI, 4.23-5.32) the actual number of donors recovered. There was a surprisingly wide variability in conversion of potential donor patients into actual donors among the hospitals studied, from 0% to 51.0%. One OPO recovered 18.8% of the potential donors, whereas the second recovered 48.2%. The performance of the OPOs was moderately related to referrals of ventilated patients and not related to center acceptance practices.<\/jats:p><\/jats:sec><jats:sec id=\"ab-soi220115-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this cross-sectional study of hospitals served by 2 OPOs, wide variation was found in the performance of the OPOs, especially at individual hospitals. Addressing this opportunity could greatly increase the organ supply, affirming the importance of recent efforts from the federal government to increase OPO accountability and transparency.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamasurg.2022.7853","type":"journal-article","created":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T16:02:24Z","timestamp":1675872144000},"page":"404","source":"Crossref","is-referenced-by-count":18,"title":["Variability in Organ Procurement Organization Performance by Individual Hospital in the United States"],"prefix":"10.1001","volume":"158","author":[{"given":"Wali","family":"Johnson","sequence":"first","affiliation":[{"name":"Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Kraft","sequence":"additional","affiliation":[{"name":"Division of Abdominal Transplant Surgery, University of Kentucky, Lexington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranit","family":"Chotai","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Lynch","sequence":"additional","affiliation":[{"name":"Department of Surgery, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S.","family":"Dittus","sequence":"additional","affiliation":[{"name":"Geriatric Research, Education and Clinical Center, VA Tennessee Valley Healthcare Center, Nashville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Division of Digestive Health and Liver Diseases, University of Miami Miller School of Medicine, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brianna","family":"Doby","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, New Mexico State University, College of Health, Education, and Social Transformation, Las Cruces"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas E.","family":"Schaubel","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malay B.","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Abdominal Transplant Surgery, University of Kentucky, Lexington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth J.","family":"Karp","sequence":"additional","affiliation":[{"name":"Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"key":"soi220115r1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2020.4391","article-title":"Using data to achieve organ procurement organization accountability\u2013reply.","author":"Karp","year":"2020","journal-title":"JAMA Surg"},{"issue":"1","key":"soi220115r2","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.v34.1","article-title":"Improvements in organ donation: riding the coattails of a national tragedy.","volume":"34","author":"Goldberg","year":"2020","journal-title":"Clin Transplant"},{"issue":"10","key":"soi220115r3","doi-asserted-by":"publisher","first-page":"2836","DOI":"10.1111\/ajt.13971","article-title":"Improving organ utilization to help 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