{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T19:04:18Z","timestamp":1757617458425,"version":"3.44.0"},"reference-count":38,"publisher":"Wiley","issue":"7-8","license":[{"start":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T00:00:00Z","timestamp":1749081600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>An efficient organ donation programme must maximise transplantation following initiation of organ recovery procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a cohort study of deceased donors in Australia (2014\u20132021) using Australia and New Zealand Organ Donation Registry data to characterise kidney non\u2010retrieval (post\u2010incision) and non\u2010utilisation (retrieved, not transplanted). Donor characteristics included kidney side (left\/right), kidney\u2010only procurement, kidney donor profile index (KDPI), cause of death, resuscitation, donation after circulatory\/neurological determination of death (DCDD\/DNDD) and donor criteria (standard SCD\/extended ECD), year, age, sex, blood group, ethnicity, comorbidities, smoking, BMI, weight, remoteness, occupation and socioeconomic disadvantage. System characteristics included jurisdiction of donor hospital, retrieval team and recipient's hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 7211 kidneys (3683 donors) accepted for retrieval, 675 (9%) were non\u2010retrieved and 430 (7%) were non\u2010utilised. Crude non\u2010retrieval rates doubled from 5% to 10% between 2014 and 2021 (<jats:italic>p<\/jats:italic>\u2009=\u20090.01) while non\u2010utilisation remained around 7% (<jats:italic>p<\/jats:italic>\u2009=\u20090.1). After adjustment, non\u2010retrieval was greater among donors with KDPI\u2009\u2265\u200975 (OR: 4.28, 95% CI: 2.08\u20138.81, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), diabetes (OR: 1.74, 95% CI: 1.25\u20132.43, <jats:italic>p<\/jats:italic>\u2009=\u20090.001) and in recent years (annual OR: 1.08, 95% CI: 1.03\u20131.55, <jats:italic>p<\/jats:italic>\u2009=\u20090.002), and lower for ECD DCDD (OR: 0.46, 95% CI: 0.26\u20130.81, <jats:italic>p<\/jats:italic>\u2009=\u20090.01). Non\u2010utilisation was greater for SCD DCDD (OR: 1.90, 95% CI: 1.28\u20132.82, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), blood group AB (OR: 2.05, 95% CI: 1.16\u20133.64, <jats:italic>p<\/jats:italic>\u2009=\u20090.03) and in recent years (annual OR: 1.08, 95% CI: 1.02\u20131.15, <jats:italic>p<\/jats:italic>\u2009=\u20090.01), and lower in Tasmania (OR: 0.28, 95% CI: 0.08\u20130.97) and Queensland (OR: 0.57, 95% CI: 0.36\u20130.92, <jats:italic>p<\/jats:italic>\u2009=\u20090.03). Documented reasons for non\u2010utilisation lacked transparency but included poor perfusion (17%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Increasing utilisation of higher KDPI kidneys and enhancing perfusion could help maximise kidney transplantation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.70208","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T05:50:23Z","timestamp":1749102623000},"page":"1584-1596","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Non\u2010Retrieval and Non\u2010Utilisation of Deceased Donor Kidneys for Transplantation: An Australian Cohort Study"],"prefix":"10.1111","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1071-0511","authenticated-orcid":false,"given":"Rachel B.","family":"Cutting","sequence":"first","affiliation":[{"name":"Sydney School of Public Health University of Sydney  Camperdown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole L.","family":"De La Mata","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health University of Sydney  Camperdown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6016-8663","authenticated-orcid":false,"given":"Animesh","family":"Singla","sequence":"additional","affiliation":[{"name":"Discipline of Surgery, Sydney Medical School, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Surgery Westmead Hospital  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James A.","family":"Hedley","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health University of Sydney  Camperdown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Opdam","sequence":"additional","affiliation":[{"name":"Organ and Tissue Authority Australian Government  Canberra Australian Capital Territory Australia"},{"name":"Intensive Care Unit Austin Hospital  Heidelberg Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Clayton","sequence":"additional","affiliation":[{"name":"Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) Royal Adelaide Hospital  Adelaide Australia"},{"name":"Faculty of Health and Medical Science University of Adelaide  Adelaide Australia"},{"name":"Central and Northern Adelaide Renal and Transplantation Service Royal Adelaide Hospital  Adelaide Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Wyburn","sequence":"additional","affiliation":[{"name":"Sydney Medical School University of Sydney  Camperdown 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