VCA Deceased Donors in the United States

Background Vascularized composite allograft (VCA) transplants include diverse organ types and are made possible primarily by deceased donors. Methods We used Organ Procurement and Transplantation Network (OPTN) data to characterize VCA deceased donors (n=66 of 70) in the United States 1998-2017 and compare their characteristics with those of kidney donors in 2017. Results Through December 31, 2017, 20 transplant programs performed 72 deceased donor VCA transplants, with organs donated by 70 donors, including 30 upper limb (17 unilateral and 13 bilateral) and 11 face donors. Other donors donated both upper limbs and face (n=2), uterus (n=4), abdominal wall (n=19), larynx (n=2), penis (n=1), and scalp (n=1). About a third of VCA donors were female, and the majority (86.4%) were white. Almost half (45.5%) were between 18 and 34 years old. Smaller proportions were under 18 (19.7%), 35-44 (15.2%), 45-54 (13.6%), and over 55 years old (6.1%). Median body mass index for all VCA donors was 24.9 and varied widely, especially for upper limb and face donors. There was considerable variation in Kidney Donor Profile Index among VCA donors (median: 27.5; interquartile range: 11-59). Donor causes of death included head trauma (39.4%), cerebrovascular/stroke (25.8%), and anoxia (31.8%). VCA donors also donated solid organs that were transplanted, including 87.1% of kidneys, 93.9% of livers, 40.2% of lungs, and 56.1% of hearts. Conclusions VCA donors are a demographically and clinically diverse group. Understanding this diversity and future trends in VCA donor characteristics is critical in supporting this life-changing field of transplantation. Corresponding Author: Jennifer L. Wainright, 700 N 4th Street, Richmond, VA 23219, jennifer.wainright@unos.org Authorship: Participated in research design: Jennifer Wainright, Christopher Wholley, John Rosendale, Wida Cherikh, David Klassen Participated in writing of paper: Jennifer Wainright, Christopher Wholley, John Rosendale, Darren Di Battista, Wida Cherikh, David Klassen Participated in performance of the research: Jennifer Wainright Participated in data analysis: Jennifer Wainright Disclosure: The authors declare no conflicts of interest. Funding: This work was conducted under the auspices of the United Network for Organ Sharing (UNOS), contractor for OPTN, under Contract 234-2005-370011C (US Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation). Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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