Shadid Anthony, Chen Carolyn, Godfrey Elizabeth L, Xu Addison, Goss John, Rana Abbas
Division of Abdominal Transplantation, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA.
UT Southwestern Medical Center, Dallas, Texas, USA.
Clin Transplant. 2025 Jul;39(7):e70231. doi: 10.1111/ctr.70231.
One of the primary limiting factors in organ transplantation is limited supply of deceased donor allografts. Although there are multiple potential strategies to increase transplantation access, increasing donor organ supply remains a priority. This study aims to analyze the origins of donor supply based on donor and hospital ZIP codes.
Organ Procurement and Transplantation Network (OPTN) deceased donor database was analyzed. ZIP codes were assigned Rural-Urban Commuting Area (RUCA) code based on definitions from the WWAMI Rural Health Research Center. These RUCA codes, ranging from 1 (metropolitan core) to 10 (rural), allowed for a census-based classification of donor residential ZIP codes. Donor density was calculated as donors per million population. Proportionality between donor rurality was compared to general mortality data from the CDC WONDER database. Statistical analysis was performed in Stata 17.0.
Rural zones and micropolitan zones supply 7.2% and 9.7% of donors despite accounting for 8.5% and 10.7% of deaths, respectively. In contrast, urban zones yield 83.1% of donors while accounting for 80.8% of deaths. Donors from rural and micropolitan regions were on average younger and more likely to have trauma-related mechanisms of death, while being less likely to be expanded criteria donors (ECD) or to have required pressor support. Lastly, rural and micropolitan donors were more likely to have written intent to donate.
The donor supply from rural and micropolitan regions is not fully reflective of their population size or donor potential. These communities may represent a valuable opportunity to expand the national donor pool through continued outreach and collaboration.
器官移植的主要限制因素之一是已故供体同种异体移植物的供应有限。尽管有多种潜在策略可增加移植机会，但增加供体器官供应仍然是首要任务。本研究旨在根据供体和医院邮政编码分析供体供应的来源。
分析了器官获取与移植网络（OPTN）的已故供体数据库。根据WWAMI农村卫生研究中心的定义，为邮政编码分配了城乡通勤区（RUCA）代码。这些RUCA代码从1（大都市核心）到10（农村），允许对供体居住邮政编码进行基于人口普查的分类。供体密度计算为每百万人口中的供体数量。将供体农村性的比例与疾病预防控制中心WONDER数据库的一般死亡率数据进行比较。在Stata 17.0中进行统计分析。
农村地区和微都市地区分别占死亡人数的8.5%和10.7%，但提供的供体分别占7.2%和9.7%。相比之下，城市地区提供了83.1%的供体，而占死亡人数的80.8%。来自农村和微都市地区的供体平均年龄较小，更有可能有与创伤相关的死亡机制，而成为扩大标准供体（ECD）或需要升压支持的可能性较小。最后，农村和微都市供体更有可能有书面捐赠意愿。
农村和微都市地区的供体供应未能充分反映其人口规模或供体潜力。通过持续的宣传和合作，这些社区可能是扩大国家供体库的宝贵机会。
