DOD

OPTN/SRTR 2015 Annual Data Report: Deceased Organ Donation

Abstract

SRTR uses data collected by OPTN to calculate metrics such as donation/conversion rate, organ yield, and rate of organs recovered for transplant but not transplanted. In 2015, 1,072,828 death and imminent death referrals were made to Organ Procurement Organizations, of which 21,559 met the definition of eligible (9793) or imminent (11,766) deaths per OPTN policy. The number of deceased donors was 9080, and this number has been increasing since 2010. The number of organs authorized for recovery increased slightly to 65,086 in 2015, and the number recovered increased slightly to 25,762. In 2015, 4370 organs were discarded, including 3157 kidneys, 311 pancreata, 703 livers, 30 hearts, and 214 lungs. These numbers suggest a need to reduce the number of organs discarded.

Introduction

This chapter reports data collected by the Organ Procurement and Transplantation Network (OPTN) to describe metrics such as donation/conversion rate, organ yield, and rate of organs recovered for transplant but not transplanted.

Definitions of Terms Related to Deceased Organ Donation

Referrals: All deaths and imminent deaths that were reported to the organ procurement organization.
Eligible death: As per OPTN policy, death of a person aged 70 years or younger who is legally declared brain dead according to hospital policy and does not exhibit any of the following indications: tuberculosis, human immunodeficiency virus (HIV) infection with specified conditions, Creutzfeldt-Jacob Disease, herpetic septicemia, rabies, reactive hepatitis B surface antigen, any retrovirus infection, active malignant neoplasms (except primary central nervous system tumors and skin cancers), Hodgkin disease, multiple myeloma, leukemia, miscellaneous carcinomas, aplastic anemia, agranulocytosis, fungal and viral encephalitis, gangrene of bowel, extreme immaturity, or positive serological or viral culture findings for HIV.
Donor: A person from whom at least one organ was procured for the purpose of transplant, regardless of whether the organ was transplanted.
Eligible donor: A donor whose death met the definition of eligible death.
Organs authorized for recovery: Consent requested and given for recovery of specific organs from a donor.
Donation/conversion rate: Number of eligible donors per 100 eligible deaths.
Organ-specific donation/conversion rate: Number of donors of each organ type who met eligibility criteria per 100 eligible deaths.
Organs recovered per donor (ORPD): Total number of organs recovered divided by the number of donors, not limited to eligible deaths.
Organs transplanted per donor (OTPD): Total number of organs transplanted divided by the number of donors, not limited to eligible deaths.
Organ yield metric: Ratio of observed to expected numbers of organs transplanted; expected numbers based on national experience with similar donors.
Rate of organs recovered for transplant but not transplanted: Calculated by dividing the number of organs recovered for the purpose of transplant but not transplanted by the number of organs recovered for the purpose of transplant.
Expanded criteria donors (ECD): Donors aged 60 years or older, or aged 50-59 years with two of the following: hypertension, terminal creatinine greater than 1.5 mg/dL, or death from cerebrovascular accident. This definition was developed by OPTN for kidney donors but has been used to classify donors in general.

Eligible Deaths

In 2015, 1,072,828 death and imminent death referrals were made to organ procurement organizations, of which 21,559 met the definition of eligible (9793) or imminent (11,766) deaths per OPTN policy. The number of deceased donors was 9080, and this number has been increasing since 2010. The number of deceased donor transplants increased to 24,980. This is in contrast to the 5989 living donor transplants in 2015 (Figure DOD 2). The number of organs authorized for recovery increased slightly to 65,086 in 2015, and the number recovered and transplanted increased to 25,762 organs (Figure DOD 3).

Donation or Conversion Rate

The OPTN requires that organ procurement organizations (OPOs) report all eligible deaths. However, any performance metric based solely on eligible deaths uses only a subset of potential donors, since successful donations can come from donors not meeting the eligible death definition, e.g., donations after cardiac death or donors aged older than 70 years. Recognizing this limitation, the SRTR's current donation/conversion rate is a measure of how often an eligible death becomes a donor. In 2015, the donation/conversation rate was 72.2 eligible donors per 100 eligible deaths, a slight decrease from 73.4 in 2014. Unadjusted donation or conversion rates varied by donation service area (DSA), ranging from 59.3 to 89.3 (Figure DOD 4).

The conversation rate varied by organ. The highest rate was 66.3 eligible donors per 100 eligible deaths for kidneys, for 6489 kidney donors from 9793 eligible deaths. The lowest conversion rate was 12.4 for pancreas donors, with 1215 donors (Figure DOD 5).

Organs Recovered per Donor

In 2015, this number was 3.51, slightly higher than 3.50 in 2014 and lower than 3.55 in 2013 (Figure DOD 6). The ORPD for each organ has been stable compared to 2014 (Figure DOD 6, Figure DOD 7). In 2015, the ORPD varied substantially by DSA, ranging from 2.89 to 4.12 (Figure DOD 8, Figure DOD 15). The ORPD is an unadjusted number and thus represents a mix of donor types, including standard criteria donors (SCDs), ECDs, and donation after circulatory death (DCD). The ORPD for kidneys varied from 1.57 to 1.96; for pancreata, from 0.02 to 0.35; for livers, from 0.58 to 0.95; for intestines, from 0.0 to 0.09; for hearts, from 0.07 to 0.44; and for lungs, from 0.12 to 0.69 (Figure DOD 9, Figure DOD 10, Figure DOD 11, Figure DOD 12, Figure DOD 13, Figure DOD 14).

Organs Transplanted per Donor and Organ Yield

The mean number of OTPD was 3.03 in 2015, similar to 2014 and slightly lower than 3.08 in 2013 (Figure DOD 16). The OTPD for each organ was stable compared to 2014 (Figure DOD 16, Figure DOD 17). In a 2015 unadjusted analysis, not accounting for the mix of SCD, ECD, and DCD donor types, the OTPD varied substantially by DSA, ranging from 2.46 to 3.71 (Figure DOD 18, Figure DOD 25). The OTPD for kidneys varied from 1.20 to 1.76; for pancreata, from 0.02 to 0.24; for livers, from 0.56 to 0.93; for intestines, from 0.0 to 0.07; for hearts, from 0.05 to 0.44; and for lungs, from 0.12 to 0.63 (Figure DOD 19, Figure DOD 20, Figure DOD 21, Figure DOD 22, Figure DOD 23, Figure DOD 24).

The OTPD from donation after brain death (DBD) was 3.25 in 2015, slightly higher than 3.22 in 2014, and slightly lower than 3.29 in 2013. The OTPD from DCD donors was 1.93 in 2015, slightly lower than 1.97 in 2014 and slightly higher than 1.88 in 2013 (Figure DOD 26). In 2015, of the 9080 donors, 16% nationally were DCD donors, slightly higher than 15% in 2014.

The average numbers of kidneys transplanted per donor were 1.44 for DBD (10,921 kidneys) and 1.56 for DCD (2332 kidneys) donors in 2015 (Figure DOD 27). The average number of kidneys transplanted varied by kidney donor profile index (KDPI), and was 1.94, 1.83, 1.55, and 0.60 for KDPI below 0.20, 0.21-0.34, 0.35-0.85, and above 0.85, respectively (Figure DOD 33). Comparing the OTPD from DBD versus DCD donors shows that, apart from kidney donors, the OTPD was higher from DBD than from DCD donors (Figure DOD 28, Figure DOD 29, Figure DOD 30, Figure DOD 31, Figure DOD 32). The OTPD for kidneys has been higher from DCD than from DBD donors since 2006 (Figure DOD 27). The number of DCD liver donors continued to increase from 184 in 2004 to 405 in 2015.

The yield metric shown compares the number of organs transplanted (observed) in 2014-2015 with the number of organs that would be expected to be transplanted in 2014-2015 based on the national experience with similar donors (expected). A ratio, expressed as observed/expected organs transplanted, of less than 1 indicates that fewer organs were transplanted than would be expected based on the national models for that organ. A ratio of greater than 1 indicates that more organs were transplanted than would be expected. The mean observed/expected ratio for all organs varied from 0.89 to 1.14. The mean observed/expected ratio for kidneys varied from 0.85 to 1.18; for pancreata, from 0.38 to 2.73; for livers, from 0.84 to 1.20; for intestines, from 0.0 to 4.10; for hearts, from 0.66 to 1.32; and for lungs, from 0.45 to 1.41 (Figure DOD 34, Figure DOD 35, Figure DOD 36, Figure DOD 37, Figure DOD 38, Figure DOD 39).

Rate of Organs Recovered for Transplant but Not Transplanted

The number of organs recovered for transplant but not transplanted is calculated by subtracting the number of organs transplanted from the number of organs recovered for the purpose of transplant. The rate of organs not transplanted is then calculated by dividing the number of organs not transplanted by the number of organs recovered for the purpose of transplant. The rate in 2015 for all organs combined was 0.14 per recovered organ, slightly higher than 0.13 in 2014 and in 2013 (Figure DOD 40). In 2015, 4370 organs were discarded, including 3157 kidneys, 311 pancreata, 703 livers, 17 intestines, 30 hearts, and 214 lungs (Figure DOD 40).

Use of DCD organs for kidney and liver transplant also varied (Figure DOD 41). The proportion of DCD donor organs among deceased donor kidney transplant recipients varied across DSAs from 0.01 to 0.39. At twelve DSAs, less than 10% of kidneys were from DCD donors. Similarly, the proportion of DCD donor organs among deceased donor liver transplant recipients varied across DSAs from 0 to 0.23 (Figure DOD 42). Four DSAs had no livers from DCD donors. The percentage of donors with KDPI greater than 0.85 also varied across the DSAs, ranging from 0 to 14.6 (Figure DOD 43). The DSAs with higher percentages of donors with KPDI greater than 0.85 were not always the same DSAs that had more DCD kidneys.

In addition to high-KDPI kidneys, other higher risk kidneys are those with increased risk of infectious disease transmission. The Centers for Disease Control and Prevention (CDC) stipulates standard criteria for donors thought to have a higher risk for infectious disease transmission. Of 2016 CDC high-risk donors in 2015, two kidneys were transplanted from 1291, one kidney from 189, and a liver from 1582.

These metrics show variation across DSAs in use of DCD donors; the highest number of discards was for kidney (3157). This suggests that sharing best practices between OPOs and their transplant centers could lead to gains in efficiency and organ retrieval, especially for marginal organs such as DCD livers and kidneys and kidneys with KDPI greater than 0.85.

The disposition of donors is described in Figure DOD 44, Figure DOD 45, Figure DOD 46, Figure DOD 47, Figure DOD 48, Figure DOD 49, Figure DOD 50, and Figure DOD 51.

Figure List

Organs transplanted per donor

Yield

Figure DOD 34. Observed-to-expected yield per kidney, 2014-2015
Figure DOD 35. Observed-to-expected yield per pancreas, 2014-2015
Figure DOD 36. Observed-to-expected yield per liver, 2014-2015
Figure DOD 37. Observed-to-expected yield per intestine, 2014-2015
Figure DOD 38. Observed-to-expected yield per heart, 2014-2015
Figure DOD 39. Observed-to-expected yield per lung, 2014-2015

Organ recovered for transplant and not transplanted

Figure DOD 40. Organs recovered for transplant and not transplanted

Organ quality

Figure DOD 41. Variation in proportions of DCD kidney donors among deceased donor transplant recipients, by DSA, 2015
Figure DOD 42. Variation in proportions of DCD liver donors among deceased donor transplant recipients, by DSA, 2015
Figure DOD 43. Variation in percentage of donors with KDPI greater than 85% among deceased donor kidney transplant recipients, by DSA, 2015

Organ use charts

Figure DOD 44. Organ use chart for reported left kidneys
Figure DOD 45. Organ use chart for reported right kidneys
Figure DOD 46. Organ use chart for reported en bloc kidneys
Figure DOD 47. Organ use chart for pancreas
Figure DOD 48. Organ use chart for liver
Figure DOD 49. Organ use chart for intestine
Figure DOD 50. Organ use chart for heart
Figure DOD 51. Organ use chart for lung

Table List

Donor characteristics

Table DOD 1. Characteristics of donors, 2005-2015

A venn diagram that illustrates the difficult conceptual definitions and relationships between donor deaths and becoming an organ donor. Basically, the true potential donor pool is only contained by in-hospital deaths but overlaps and is not contained by referrals to OPO, eligible deaths. — **Figure DOD 1. Relationship between deaths, donations, and transplants**
Conceptual schematic (Venn diagram) of actual and potential organ donors. A. Only in rare instances do out-of-hospital deaths result in organ donation. B. Most in-hospital deaths are reported to the local organ procurement organization. C. The number of "True" Potential Donors (dashed circle) is yet to be defined. D. Eligible Deaths. E. Actual donors, not all of whom result in transplants. F. Deceased donor transplants. OPO, organ procurement organization.

A line plot for overall counts of eligible deaths, donors, and transplants, 2004-2015; the in to hospital deaths category is NA count at 2004 and is count at 2015; the eligible deaths category is NA count at 2004 and is count at 2015; the deceased donors category increases by 27.0% from 7150 count at 2004 to 9080 count at 2015; the deceased donors meeting eligibility criteria category is NA count at 2004 and is count at 2015; the total transplants category increases by 14.5% from 27053 count at 2004 to 30969 count at 2015; and the deceased donor only transplants category increases by 24.6% from 20049 count at 2004 to 24980 count at 2015. — **Figure DOD 2. Overall counts of eligible deaths, donors, and transplants, 2004-2015**
The number and source of donors with the number of transplants.

A line plot for overall counts of authorized and recovered organs, 2004-2015; the organs authorized category increases by 35.7% from 47970 count of organs at 2004 to 65086 count of organs at 2015; and the organs transplanted category increases by 22.5% from 21025 count of organs at 2004 to 25762 count of organs at 2015. — **Figure DOD 3. Overall counts of authorized and recovered organs, 2004-2015**
The number of authorized and recovered organs.

A map of overall donations per 100 eligible deaths by dsa, 2015, the values range from 59.34 to 89.29. — **Figure DOD 4. Overall donations per 100 eligible deaths by DSA, 2015**
Donation rate is the number of deceased donors meeting eligibility criteria per 100 eligible deaths. An eligible death is any hospital-reported death or imminent death that is evaluated and meets organ donor eligibility requirements, with none of the exclusions listed in OPTN policy.

A bar plot for overall and organ-specific donations per 100 eligible deaths, 2015, the all group is 72.18 percent; the kidney group is 66.26 percent; the pancreas group is 12.41 percent; the liver group is 65.33 percent; the heart group is 28.90 percent; and the lung group is 19.49 percent. — **Figure DOD 5. Overall and organ-specific donations per 100 eligible deaths, 2015**
Organ-specific rates represent the number of donors of each organ type meeting eligibility criteria per 100 eligible deaths.

A line plot for organs recovered per donor, all organs and kidney; the all category is 3.5 NA at 2004 and remains relatively constant with a value of 3.5 NA at 2015; and the kidneys category is 1.8 NA at 2004 and remains relatively constant with a value of 1.8 NA at 2015. — **Figure DOD 6. Organs recovered per donor, all organs and kidney**
Average number of overall organs and kidneys recovered per donor, calculated as the sum of recovered organs and by organ type; i.e., up to two kidneys can be recovered from each donor, but only one heart. Pancreata recovered for islet transplant are excluded.

A line plot for organs recovered per donor, pancreas, liver, intestine, heart, and lung; the pancreas category decreases by 48.3% from 0.3 NA at 2004 to 0.1 NA at 2015; the liver category is 0.9 NA at 2004 and remains relatively constant with a value of 0.8 NA at 2015; the intestine category decreases by 26.0% from 0 NA at 2004 to 0 NA at 2015; the heart category is 0.3 NA at 2004 and remains relatively constant with a value of 0.3 NA at 2015; and the lung category increases by 51.5% from 0.3 NA at 2004 to 0.4 NA at 2015. — **Figure DOD 7. Organs recovered per donor, pancreas, liver, intestine, heart, and lung**
Average number of organs other than kidneys recovered per donor, calculated as the sum of recovered organs and by organ type. Pancreata recovered for islet transplant are excluded.

A density plot for dsa distribution of all organs recovered per donor, 2015, the values range from 2.89 to 4.12. — **Figure DOD 8. DSA distribution of all organs recovered per donor, 2015**
Average number of organs recovered per donor, calculated as the sum of recovered organs and by organ type; i.e., up to two kidneys can be recovered from each donor, but only one heart. DSA-level means are shown. Pancreata recovered for islet transplant are excluded. The vertical line indicates the mean of the DSA-level means.

A density plot for dsa distribution of kidneys recovered per donor, 2015, the values range from 1.58 to 1.96. — **Figure DOD 9. DSA distribution of kidneys recovered per donor, 2015**
Average number of kidneys recovered per donor, calculated as the sum of recovered organs and by organ type. DSA-level means are shown. The vertical line indicates the mean of the DSA-level means.

A density plot for dsa distribution of pancreata recovered per donor, 2015, the values range from 0.02 to 0.36. — **Figure DOD 10. DSA distribution of pancreata recovered per donor, 2015**
Average number of pancreata recovered per donor, calculated as the sum of recovered organs and by organ type. DSA-level means are shown. Pancreata recovered for islet transplant are excluded. The vertical line indicates the mean of the DSA-level means.

A density plot for dsa distribution of livers recovered per donor, 2015, the values range from 0.58 to 0.95. — **Figure DOD 11. DSA distribution of livers recovered per donor, 2015**
Average number of livers recovered per donor, calculated as the sum of recovered organs and by organ type. DSA-level means are shown. The vertical line indicates the mean of the DSA-level means.

A density plot for dsa distribution of intestines recovered per donor, 2015, the values range from 0.00 to 0.09. — **Figure DOD 12. DSA distribution of intestines recovered per donor, 2015**
Average number of intestines recovered per donor, calculated as the sum of recovered organs and by organ type. DSA-level means are shown. The vertical line indicates the mean of the DSA-level means.

A density plot for dsa distribution of hearts recovered per donor, 2015, the values range from 0.08 to 0.44. — **Figure DOD 13. DSA distribution of hearts recovered per donor, 2015**
Average number of hearts recovered per donor, calculated as the sum of recovered organs and by organ type. DSA-level means are shown. The vertical line indicates the mean of the DSA-level means.

A density plot for dsa distribution of lungs recovered per donor, 2015, the values range from 0.12 to 0.69. — **Figure DOD 14. DSA distribution of lungs recovered per donor, 2015**
Average number of lungs recovered per donor, calculated as the sum of recovered organs and by organ type. DSA-level means are shown. The vertical line indicates the mean of the DSA-level means.

A map of organs recovered per donor by dsa, 2015, the values range from 2.89 to 4.12. — **Figure DOD 15. Organs recovered per donor by DSA, 2015**
Average number of organs recovered per donor, calculated as the sum of recovered organs and by organ type; i.e., up to two kidneys can be recovered from each donor, but only one heart. Pancreata recovered for islet transplant are excluded.

A line plot for organs transplanted per donor, all organs and kidney; the all category is 3.1 NA at 2004 and remains relatively constant with a value of 3 NA at 2015; and the kidneys category is 1.5 NA at 2004 and remains relatively constant with a value of 1.5 NA at 2015. — **Figure DOD 16. Organs transplanted per donor, all organs and kidney**
Average number of overall organs and kidneys transplanted per donor. As organs divided into segments (liver, lung, pancreas, intestine) may account for more than one transplant, the number or organs transplanted may exceed the number recovered. Based on a count of recovered organs that are transplanted, which differs from number of transplant operations. DSA-level means are shown. Pancreata recovered for islet transplant are excluded.

A line plot for organs transplanted per donor, pancreas, liver, intestine, heart, and lung; the pancreas category decreases by 49.7% from 0.2 NA at 2004 to 0.1 NA at 2015; the liver category is 0.8 NA at 2004 and remains relatively constant with a value of 0.7 NA at 2015; the intestine category decreases by 25.0% from 0 NA at 2004 to 0 NA at 2015; the heart category is 0.3 NA at 2004 and remains relatively constant with a value of 0.3 NA at 2015; and the lung category increases by 48.4% from 0.3 NA at 2004 to 0.4 NA at 2015. — **Figure DOD 17. Organs transplanted per donor, pancreas, liver, intestine, heart, and lung**
Average number of organs other than kidneys transplanted per donor. As organs divided into segments (liver, lung, pancreas, intestine) may account for more than one transplant, the number or organs transplanted may exceed the number recovered. Based on a count of recovered organs that are transplanted, which differs from number of transplant operations. DSA-level means are shown. Pancreata recovered for islet transplant are excluded.

A density plot for dsa distribution of all organs transplanted per donor, 2015, the values range from 2.46 to 3.71. — **Figure DOD 18. DSA distribution of all organs transplanted per donor, 2015**
Average number of organs transplanted per donor. As organs divided into segments (liver, lung, pancreas, intestine) may account for more than one transplant, the number of organs transplanted may exceed the number recovered. Based on a count of recovered organs that are transplanted, which differs from number of transplant operations. DSA-level means are shown. Pancreata recovered for islet transplant are excluded. The vertical line indicates the mean of the DSA-level means.

A density plot for dsa distribution of kidneys transplanted per donor, 2015, the values range from 1.20 to 1.76. — **Figure DOD 19. DSA distribution of kidneys transplanted per donor, 2015**
Average number of kidneys transplanted per donor. Based on a count of recovered kidneys that are transplanted, which differs from number of transplant operations. DSA-level means are shown. The vertical line indicates the mean of the DSA-level means.

A density plot for dsa distribution of pancreata transplanted per donor, 2015, the values range from 0.02 to 0.24. — **Figure DOD 20. DSA distribution of pancreata transplanted per donor, 2015**
Average number of pancreata transplanted per donor. Pancreata divided into segments may account for more than one transplant, the number of pancreata transplanted may exceed the number recovered. Based on a count of recovered pancreata that are transplanted, which differs from number of transplant operations. DSA-level means are shown. Pancreata recovered for islet transplant are excluded. The vertical line indicates the mean of the DSA-level means.

A density plot for dsa distrbution of livers transplanted per donor, 2015, the values range from 0.56 to 0.93. — **Figure DOD 21. DSA distrbution of livers transplanted per donor, 2015**
Average number of livers transplanted per donor. Livers divided into segments may account for more than one transplant, the number of livers transplanted may exceed the number recovered. Based on a count of recovered livers that are transplanted, which differs from number of transplant operations. DSA-level means are shown. The vertical line indicates the mean of the DSA-level means.

A density plot for dsa distribution of intestines transplanted per donor, 2015, the values range from 0.00 to 0.07. — **Figure DOD 22. DSA distribution of intestines transplanted per donor, 2015**
Average number of intestines transplanted per donor. Intestines divided into segments may account for more than one transplant, the number of intestines transplanted may exceed the number recovered. Based on a count of recovered intestines that are transplanted, which differs from number of transplant operations. DSA-level means are shown. The vertical line indicates the mean of the DSA-level means.

A density plot for dsa distrbution of hearts transplanted per donor, 2015, the values range from 0.05 to 0.44. — **Figure DOD 23. DSA distrbution of hearts transplanted per donor, 2015**
Average number of hearts transplanted per donor. Based on a count of recovered hearts that are transplanted, which differs from number of transplant operations. DSA-level means are shown. The vertical line indicates the mean of the DSA-level means.

A density plot for dsa distribution of lungs transplanted per donor, 2015, the values range from 0.12 to 0.63. — **Figure DOD 24. DSA distribution of lungs transplanted per donor, 2015**
Average number of lungs transplanted per donor. Lungs divided into segments may account for more than one transplant, the number of lungs transplanted may exceed the number recovered. Based on a count of recovered lungs that are transplanted, which differs from number of transplant operations. DSA-level means are shown. The vertical line indicates the mean of the DSA-level means.

A map of organs transplanted per donor, by dsa, 2015, the values range from 2.46 to 3.71. — **Figure DOD 25. Organs transplanted per donor, by DSA, 2015**
Average number of organs transplanted per donor. As organs divided into segments (liver, lung, pancreas, intestine) may account for more than one transplant, the number or organs transplanted may exceed the number recovered. Based on a count of recovered organs that are transplanted, which differs from number of transplant operations. DSA-level means are shown. Pancreata recovered for islet transplant are excluded.

A line plot for organs transplanted per donor, by dbd and dcd status; the dbd category is 3.1 NA at 2004 and remains relatively constant with a value of 3.2 NA at 2015; and the dcd category is 2 NA at 2004 and remains relatively constant with a value of 1.9 NA at 2015. — **Figure DOD 26. Organs transplanted per donor, by DBD and DCD status**
Average number of organs transplanted per donor. As organs divided into segments (liver, lung, pancreas, intestine) may account for more than one transplant, the number of organs transplanted may exceed the number recovered. Based on a count of recovered organs that are transplanted, which differs from number of transplant operations. DSA-level means are shown. Pancreata recovered for islet transplant are excluded.

A line plot for kidneys transplanted per donor, by dbd and dcd status; the dbd category is 1.5 NA at 2004 and remains relatively constant with a value of 1.4 NA at 2015; and the dcd category is 1.4 NA at 2004 and remains relatively constant with a value of 1.6 NA at 2015. — **Figure DOD 27. Kidneys transplanted per donor, by DBD and DCD status**
Average number of kidneys transplanted per donor. Based on a count of recovered kidneys that are transplanted, which differs from number of transplant operations. DSA-level means are shown.

A line plot for pancreata transplanted per donor, by dbd and dcd status; the dbd category decreases by 43.5% from 0.2 NA at 2004 to 0.1 NA at 2015; and the dcd category decreases by 76.5% from 0.1 NA at 2004 to 0 NA at 2015. — **Figure DOD 28. Pancreata transplanted per donor, by DBD and DCD status**
Average number of pancreata transplanted per donor. Pancreata divided into segments may account for more than one transplant, the number of pancreata transplanted may exceed the number recovered. Based on a count of recovered pancreata that are transplanted, which differs from number of transplant operations. DSA-level means are shown. Pancreata recovered for islet transplant are excluded.

A line plot for livers transplanted per donor, by dbd and dcd status; the dbd category is 0.8 NA at 2004 and remains relatively constant with a value of 0.8 NA at 2015; and the dcd category decreases by 42.1% from 0.5 NA at 2004 to 0.3 NA at 2015. — **Figure DOD 29. Livers transplanted per donor, by DBD and DCD status**
Average number of livers transplanted per donor. Livers divided into segments may account for more than one transplant, the number of livers transplanted may exceed the number recovered. Based on a count of recovered livers that are transplanted, which differs from number of transplant operations. DSA-level means are shown.

A line plot for intestines transplanted per donor, by dbd and dcd status; the dbd category decreases by 15.2% from 0 NA at 2004 to 0 NA at 2015; and the dcd category is 0 NA at 2004 and is NA at 2015. — **Figure DOD 30. Intestines transplanted per donor, by DBD and DCD status**
Average number of intestines transplanted per donor. Intestines divided into segments may account for more than one transplant, the number of intestines transplanted may exceed the number recovered. Based on a count of recovered intestines that are transplanted, which differs from number of transplant operations. DSA-level means are shown.

A line plot for hearts transplanted per donor, by dbd and dcd status; the dbd category increases by 21.3% from 0.3 NA at 2004 to 0.4 NA at 2015; and the dcd category decreases by 100.0% from 0 NA at 2004 to 0 NA at 2015. — **Figure DOD 31. Hearts transplanted per donor, by DBD and DCD status**
Average number of hearts transplanted per donor. Based on a count of recovered hearts that are transplanted, which differs from number of transplant operations. DSA-level means are shown.

A line plot for lungs transplanted per donor, by dbd and dcd status; the dbd category increases by 63.4% from 0.3 NA at 2004 to 0.5 NA at 2015; and the dcd category increases by 199.9% from 0 NA at 2004 to 0.1 NA at 2015. — **Figure DOD 32. Lungs transplanted per donor, by DBD and DCD status**
Average number of lungs transplanted per donor. Lungs divided into segments may account for more than one transplant, the number of lungs transplanted may exceed the number recovered. Based on a count of recovered lungs that are transplanted, which differs from number of transplant operations. DSA-level means are shown.

A line plot for kidneys transplanted per donor, by kdpi; the kdpi less than or equal to 0.20 category is 1.9 NA at 2004 and remains relatively constant with a value of 1.9 NA at 2015; the kdpi 0.21 to 0.34 category is 1.8 NA at 2004 and remains relatively constant with a value of 1.8 NA at 2015; the kdpi 0.35 to 0.85 category is 1.6 NA at 2004 and remains relatively constant with a value of 1.6 NA at 2015; and the kdpi greater than 0.85 category decreases by 14.9% from 0.7 NA at 2004 to 0.6 NA at 2015. — **Figure DOD 33. Kidneys transplanted per donor, by KDPI**
Average number of kidneys transplanted per donor. Based on a count of recovered kidneys that are transplanted, which differs from number of transplant operations. KDPI, kidney donor profile index.

A bubble plot for observed-to-expected yield per kidney, 2014-2015, the Number of Donors ranges from 82 to 930 with the Obs/Exp Ratio ranging from 0.85 to 1.18. — **Figure DOD 34. Observed-to-expected yield per kidney, 2014-2015**
Donor yield is a measure of organs transplanted per donor. Expected yield is estimated from statistical models that take into account various charasteristics not under the control of OPOs. Kidney transplants are counted separately as zero, one, or two. The circles represent the 58 OPOs.

A bubble plot for observed-to-expected yield per pancreas, 2014-2015, the Number of Donors ranges from 82 to 930 with the Obs/Exp Ratio ranging from 0.38 to 2.73. — **Figure DOD 35. Observed-to-expected yield per pancreas, 2014-2015**
Donor yield is a measure of organs transplanted per donor. Expected yield is estimated from statistical models that take into account various charasteristics not under the control of OPOs. The circles represent the 58 OPOs.

A bubble plot for observed-to-expected yield per liver, 2014-2015, the Number of Donors ranges from 82 to 930 with the Obs/Exp Ratio ranging from 0.84 to 1.20. — **Figure DOD 36. Observed-to-expected yield per liver, 2014-2015**
Donor yield is a measure of organs transplanted per donor. Expected yield is estimated from statistical models that take into account various charasteristics not under the control of OPOs. The circles represent the 58 OPOs.

A bubble plot for observed-to-expected yield per intestine, 2014-2015, the Number of Donors ranges from 82 to 930 with the Obs/Exp Ratio ranging from 0.00 to 4.10. — **Figure DOD 37. Observed-to-expected yield per intestine, 2014-2015**
Donor yield is a measure of organs transplanted per donor. Expected yield is estimated from statistical models that take into account various charasteristics not under the control of OPOs. The circles represent the 58 OPOs.

A bubble plot for observed-to-expected yield per heart, 2014-2015, the Number of Donors ranges from 82 to 930 with the Obs/Exp Ratio ranging from 0.66 to 1.32. — **Figure DOD 38. Observed-to-expected yield per heart, 2014-2015**
Donor yield is a measure of organs transplanted per donor. Expected yield is estimated from statistical models that take into account various charasteristics not under the control of OPOs. The circles represent the 58 OPOs.

A bubble plot for observed-to-expected yield per lung, 2014-2015, the Number of Donors ranges from 82 to 930 with the Obs/Exp Ratio ranging from 0.45 to 1.41. — **Figure DOD 39. Observed-to-expected yield per lung, 2014-2015**
Donor yield is a measure of organs transplanted per donor. Expected yield is estimated from statistical models that take into account various charasteristics not under the control of OPOs. Single-lung and double-lung transplants are both counted as one organ transplant. The circles represent the 58 OPOs.

A line plot for organs recovered for transplant and not transplanted; the total category increases by 10.5% from 0.1 NA at 2004 to 0.1 NA at 2015; the kidney category increases by 16.0% from 0.2 NA at 2004 to 0.2 NA at 2015; the pancreas category is 0.2 NA at 2004 and remains relatively constant with a value of 0.2 NA at 2015; the liver category increases by 10.5% from 0.1 NA at 2004 to 0.1 NA at 2015; the intestine category is 0.1 NA at 2004 and remains relatively constant with a value of 0.1 NA at 2015; the heart category is 0 NA at 2004 and remains relatively constant with a value of 0 NA at 2015; and the lung category increases by 54.5% from 0 NA at 2004 to 0.1 NA at 2015. — **Figure DOD 40. Organs recovered for transplant and not transplanted**
Rates are calculated as the difference between the number of organs recovered and the number of organs transplanted, divided by the number of organs recovered. Pancreata recovered for islet transplant are excluded.

A map of variation in proportions of dcd kidney donors among deceased donor transplant recipients, by dsa, 2015, the values range from 0.01 to 0.39. — **Figure DOD 41. Variation in proportions of DCD kidney donors among deceased donor transplant recipients, by DSA, 2015**
DCD kidney donors for deceased donor transplant recipients (as defined in Figures DOD 4.1-4.3). DCD, donation after circulatory death.

A map of variation in proportions of dcd liver donors among deceased donor transplant recipients, by dsa, 2015, the values range from 0.00 to 0.23. — **Figure DOD 42. Variation in proportions of DCD liver donors among deceased donor transplant recipients, by DSA, 2015**
DCD liver donors for deceased donor transplant recipients (as defined in Figures DOD 4.1-4.3). DCD, donation after circulatory death.

A map of variation in percentage of donors with kdpi greater than 85% among deceased donor kidney transplant recipients, by dsa, 2015, the values range from 1.03 to 14.67. — **Figure DOD 43. Variation in percentage of donors with KDPI greater than 85% among deceased donor kidney transplant recipients, by DSA, 2015**
Percentage of deceased donor transplants within an DSA with KDPI greater than, or equal to, 85%.

A chart that summarizes the donor disposition, or organ use, of donated left kidneys. The most common disposition is transplante — **Figure DOD 44. Organ use chart for reported left kidneys**
A summary of the consent, recovered, tranplanted or discarded status for donated left kidneys. The number of left and right kidneys may not equal the total number of donors.

A chart that summarizes the donor disposition, or organ use, of donated right kidneys. The most common disposition is Transplanted (6,287, 73.0%) followed by recovered for transplant but not transplanted (1,556, 18.1%). 660 (7.7%) of right kidneys were not recovered. — **Figure DOD 45. Organ use chart for reported right kidneys**
A summary of the consent, recovered, tranplanted or discarded status for donated right kidneys. The number of left and right kidneys may not equal the total number of donors.

A chart that summarizes the donor disposition, or organ use, of donated en bloc kidneys. The most common disposition is transplanted (285, 61.7%) followed by recovered for transplant but not transplanted (78, 16.9%). 63 (13.6%) of right kidneys were not recovered. — **Figure DOD 46. Organ use chart for reported en bloc kidneys**
A summary of the consent, recovered, tranplanted or discarded status for donated en bloc kidneys. The number of en bloc kidneys may not equal the total number of donors.

A chart that summarizes the donor disposition, or organ use, of donated pancreas. The most common disposition is not recovered (6,872, 75.7%) followed by transplanted (950, 10.5%). 320 (3.5%) of pancreas were recovered for transplant but not transplanted. — **Figure DOD 47. Organ use chart for pancreas**
A summary of the consent, recovered, tranplanted or discarded status for donated pancreas.

A chart that summarizes the donor disposition, or organ use, of donated livers. The most common disposition is transplanted (6,714, 73.9%) followed by not recovered (1,224, 13.5%). 703 (7.7%) of livers were recovered for transplant but not transplanted. — **Figure DOD 48. Organ use chart for liver**
A summary of the consent, recovered, tranplanted or discarded status for donated livers.

A chart that summarizes the donor disposition, or organ use, of donated intestines. The most common disposition is not recovered (8,127, 89.5%) followed by consent not obtained (338, 3.7%). 139 (1.5%) of intestines were transplanted and 17 (0.2%) were recovered for transplant but not transplanted. — **Figure DOD 49. Organ use chart for intestine**
A summary of the consent, recovered, tranplanted or discarded status for donated intestines.

A chart that summarizes the donor disposition, or organ use, of donated hearts. The most common disposition is not recovered (4,664, 51.4%) followed by transplanted (2,824, 31.1%). 30 (0.3%) of hearts were recovered for transplant but not transplanted. — **Figure DOD 50. Organ use chart for heart**
A summary of the consent, recovered, tranplanted or discarded status for donated hearts.

A chart that summarizes the donor disposition, or organ use, of donated lungs. The most common disposition is not recovered (5,452, 60.0%) followed by transplanted (1,933, 21.3%). 85 (0.9%) of lungs are recovered for transplant but not transplanted. — **Figure DOD 51. Organ use chart for lung**
A summary of the consent, recovered, tranplanted or discarded status for donated lungs.

**Table DOD 1 Characteristics of donors, 2005-2015**
The donor characteristics of age, sex, race/ethnicity and DCD status in 2005 and 2015.
Characteristic	2005, N	2005, Percent	2015, N	2015, Percent
Age: <18 years	3473	13.6%	3348	11.1%
Age: 18-34 years	8302	32.4%	10,879	36.2%
Age: 35-49 years	6624	25.9%	7726	25.7%
Age: 50-64 years	5528	21.6%	6694	22.3%
Age: ≥65 years	1676	6.5%	1413	4.7%
Sex: Female	10,109	39.5%	11,458	38.1%
Sex: Male	15,494	60.5%	18,602	61.9%
Race/ethnicity: White	17,488	68.3%	19,491	64.8%
Race/ethnicity: Black	3766	14.7%	5243	17.4%
Race/ethnicity: Hispanic	3590	14.0%	4288	14.3%
Race/ethnicity: Other/unkown	759	3.0%	1038	3.5%
DCD status: DBD	24,353	95.1%	26,787	89.1%
DCD status: DCD	1250	4.9%	3273	10.9%