Open AccessRisk Indices in Deceased-donor Organ Allocation for Transplantation: Review From an Australian Perspective
Author(s) -
Jonathan Ling,
Michael A Fink,
Glen Westall,
Peter Macdonald,
Philip Clayton,
Rhonda Holdsworth,
Helen Opdam,
Kevan R. Polkinghorne,
John Kanellis
Publication year - 2019
Publication title -
transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.45
H-Index - 204
eISSN - 1534-6080
pISSN - 0041-1337
DOI - 10.1097/tp.0000000000002613
Subject(s) - organ donation , perspective (graphical) , intensive care medicine , transplantation , medicine , organ transplantation , operations management , actuarial science , risk analysis (engineering) , computer science , business , surgery , economics , artificial intelligence
Over the last decade, organ donation and transplantation rates have increased in Australia and worldwide. Donor and recipient characteristics for most organ types have generally broadened, resulting in the need to consider more complex data in transplant decision-making. As a result of some of these pressures, the Australian software used for donor and recipient data management is currently being updated. Because of the in-built capacity for improved data management, organ allocation processes will have the opportunity to be significantly reviewed, in particular the possible use of risk indices (RIs) to guide organ allocation and transplantation decisions. We aimed to review RIs used in organ allocation policies worldwide and to compare their use to current Australian protocols. Significant donor, recipient, and transplant variables in the indices were summarized. We conclude that Australia has the opportunity to incorporate greater use of RIs in its allocation policies and in transplant decision-making processes. However, while RIs can assist with organ allocation and help guide prognosis, they often have significant limitations which need to be properly appreciated when deciding how to best use them to guide clinical decisions.