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DOD

OPTN/SRTR 2016 Annual Data Report: Deceased Organ Donation

Abstract

SRTR uses data collected by OPTN to calculate metrics such as donation rate, organ yield, and rate of organs recovered for transplant but not transplanted. In 2016, 1,072,717 death and imminent death referrals were made to organ procurement organizations, of which 23,433 met the definition of eligible (10,717) or imminent (12,716) deaths per OPTN policy. There were 9971 deceased donors, and this number has been increasing since 2010. The number of organs authorized for recovery has also continued to increase since 2010. In 2016, 4859 organs were discarded, including 3631 kidneys, 317 pancreata, 739 livers, 8 intestines, 31 hearts, and 211 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 rate, organ yield, and rate of organs recovered for transplant but not transplanted.

Definitions of Terms Related to Deceased Organ Donation

  • All deaths and imminent deaths that were reported to the organ procurement organization (OPO).
  • Eligible death: As per OPTN policy 1.2 in place during 2016, 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 recovered 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. Recovery of organs for transplant must be specifically authorized by the individual(s) authorizing the donation, whether that is the donor or a surrogate donation decision maker, consistent with applicable state law.
  • Donation rate: Number of eligible donors 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. For example, the OTPD for kidneys is the total number of kidneys transplanted divided by the total number of all donors.
  • Organ yield metric: Ratio of observed to expected numbers of organs transplanted; expected numbers based on national experience with similar donors.
  • Organs recovered for transplant but not transplanted: This is 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.
  • DBD: Donations after brain death.
  • DCD: Donations after circulatory death.

Donors

In 2016, 1,072,717 death and imminent death referrals were reported to OPTN by OPOs, of which 23,433 met the definition of eligible (10,717) or imminent (12,716) deaths as defined by OPTN policy. The number of eligible deaths increased from 8947 in 2012. There were 9971 deceased donors, and this number has been increasing since 2010. The number of deceased donor transplants increased to 27,622 from 24,980 in 2015. This is in contrast to the decline or lack of growth in numbers of deceased donor transplants in previous years. Also in contrast, 5976 living donor transplants were performed in 2016, a slight decreased from 5989 in 2015 (Figure DOD 2). Numbers of donations after brain death (DBD) and after circulatory death (DCD) increased to 8287 and 1684, respectively, continuing a steady increase since 2010 (Figure DOD 3). The number of organs authorized for recovery continued to increase to 71,550 from 55,348 since 2010 (Figure DOD 4). Potential reasons for the growth in donors and numbers of deceased donor transplants include the rising number of deaths of young individuals due to the opioid epidemic and increasing use of organs from DBD donors.

Donation Rate

OPTN requires that OPOs report all eligible deaths for OPO performance assessment. 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., donation after circulatory death (DCD) or donors aged older than 70 years. Recognizing this limitation, SRTR’s current donation rate is a measure of how often an eligible death becomes a donor. In 2016, the donation rate was 72.3 eligible donors per 100 eligible deaths, a slight increase from 72.2 in 2015 and a slight decrease from 73.4 in 2014. Unadjusted donation rates varied by donation service area (DSA), ranging from 52.9 to 93.3 (Figure DOD 5). This range increased slightly from 2015, when it varied from 59.3 to 89.3. Since the donation rate is unadjusted, the variation across DSAs should be interpreted with caution.

The donation rate varied by organ. The highest rate was 66.7 eligible donors per 100 eligible deaths for kidneys, for 7143 kidney donors from 10,717 eligible deaths. The next highest donation rate was 65.6 for liver, from 7041 liver donors. The lowest donation rate was 12.0 for pancreas donors, from 1283 donors (Figure DOD 6).

Organs Recovered per Donor

In 2016, 3.54 organs were recovered per donor, slightly higher than 3.51 in 2015 and 3.50 in 2014 (Figure DOD 7). The ORPD for all organs combined has been relatively stable compared with 2014 (Figure DOD 7, Figure DOD 8). Given that each donor can potentially donate two kidneys, the ORPD was highest for kidneys, followed by livers (Figure DOD 7, Figure DOD 8). ORPDs have increased for hearts and lungs over the past decade, and have declined for pancreata (Figure DOD 8). In 2016, the ORPD varied substantially by DSA, ranging from 2.90 to 4.19, a larger range than 2.89 to 4.12 in 2015 (Figure DOD 9). The ORPD is an unadjusted number, and thus represents a mix of donor types, including young and old and DBD and DCD donors. The ORPD for kidneys varied from 1.54 to 2.00; for pancreata, from 0 to 0.32; for livers, from 0.52 to 0.95; for intestines, from 0.0 to 0.12; for hearts, from 0 to 0.43; and for lungs, from 0.05 to 0.77 (Figure DOD 9).

Organs Transplanted per Donor and Organ Yield

The number of OTPD was 3.06 in 2016, slightly increased from 3.03 in 2015 and 2014 (Figure DOD 10). The OTPD for all organs combined was stable compared with 2014 (Figure DOD 10). Given that each donor can potentially donate two kidneys, the OTPD was highest for kidneys, followed by livers (Figure DOD 10, Figure DOD 11). OTPD increased for hearts and lungs over the past decade, but declined for pancreata (Figure DOD 11). In a 2015 unadjusted analysis, not accounting for the mix of DBD and DCD donor types, OTPD varied substantially by DSA, ranging from 2.28 to 3.80, a wider range than 2.46 to 3.71 in 2015 (Figures DOD 12). In 2016, the OTPD for kidneys varied by DSA from 1.13 to 1.85; for pancreata, from 0 to 0.26; for livers, from 0.49 to 0.94; for intestines, from 0 to 0.12; for hearts, from 0 to 0.43; and for lungs, from 0.05 to 0.72.

The OTPD from DBD donors was 3.29 in 2016, slightly higher than 3.25 in 2015 and 3.22 in 2014. The OTPD from DCD donors was 1.93 in 2016, the same as in 2015, and slightly lower than 1.97 in 2014 (Figure DOD 13). In 2016, of the 9971 donors, 16.8% nationally were DCD donors, slightly higher than 16% in 2015 and 15% in 2014.

In 2016, the average numbers of kidneys transplanted per donor were 1.43 for DBD (11,890 kidneys, higher than 10,919 in 2015) and 1.55 for DCD (2611 kidneys, higher than 2322 in 2015) donors (Figure DOD 14). The average number of kidneys transplanted varied by kidney donor profile index (KDPI), and was 1.92, 1.85, 1.53, and 0.62 for KDPI < 0.20, 0.21-0.34, 0.35-0.85, and > 0.85, respectively (Figure DOD 20). Apart from kidney donors, OTPD was higher from DBD than from DCD donors (Figure DOD 14, Figure DOD 15, Figure DOD 16, Figure DOD 17, Figure DOD 18, Figure DOD 19). The OTPD for kidneys has been higher from DCD than from DBD donors since 2006 (Figure DOD 14). The number of DCD liver donors continued to increase, from 405 in 2015 to 450 in 2016. Similarly, the number of DCD lungs continued to increase, from 114 in 2015 to 163 in 2016.

The yield metric shown in Figure DOD 21, Figure DOD 22, Figure DOD 23, Figure DOD 24, Figure DOD 25, and Figure DOD 26 compares the number of organs transplanted (observed) in 2015-2016 with the number of organs that would be expected to be transplanted based on the national experience with similar donors (expected). A ratio, expressed as observed/expected organs transplanted, of < 1 indicates that fewer organs were transplanted than would be expected based on the national models for that organ. A ratio of > 1 indicates that more organs were transplanted than would be expected. The mean observed/expected ratio for all organs varied from 0.92 to 1.08. The mean observed/expected ratio for kidneys varied from 0.90 to 1.13; for pancreata, from 0.14 to 2.70; for livers, from 0.82 to 1.16; for intestines, from 0 to 4.49; for hearts, from 0.68 to 1.31; and for lungs, from 0.55 to 1.39.

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 percentage 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 percentage in 2016 for all organs combined was 13.8 per recovered organ, the same as in 2015 and slightly higher than 13.7 in 2014 (Figure DOD 27). In 2016, 4859 organs were discarded (4368 in 2015), including 3631 kidneys, 317 pancreata, 739 livers, 8 intestines, 31 hearts, and 211 lungs (Figure DOD 27). The numbers of kidneys and livers discarded increased from 3157 and 703, respectively, in 2015.

DCD organs and Disposition of donors

Use of DCD organs also varied (Figure DOD 28). The percentage of DCD donor organs among deceased donor transplant recipients varied across DSAs from 0 to 37.7. The percentage of donors with KDPI > 0.85 also varied across the DSAs, ranging from 0 to 25.2 (Figure DOD 29).

The disposition of donors is described in Figure DOD 30, Figure DOD 31, Figure DOD 32, Figure DOD 33, Figure DOD 34, Figure DOD 35, Figure DOD 36 and Figure DOD 37. Donor characteristics in 2016 are compared with characteristics in 2006 in Table DOD 1. The most remarkable differences were the increase in DCD donors from 6.7% in 2006 to 15.0% in 2016, and the increase in donors aged 18-34 years from 25.6% to 31.1%, possibly reflecting increased deaths due to the opioid abuse epidemic.

Figure List

Summary

Figure DOD 1. Relationship between deaths, donations, and transplants
Figure DOD 2. Overall counts of eligible deaths, donors, and transplants, 2005-2016
Figure DOD 3. Overall counts of deceased donors, dbd donors, and dcd donors, 2005-2016
Figure DOD 4. Overall counts of authorized and transplanted organs, 2005-2016

Donation rates

Figure DOD 5. Overall donations per 100 eligible deaths by DSA, 2016
Figure DOD 6. Overall and organ-specific donations per 100 eligible deaths, 2016

Organs recovered per donor

Figure DOD 7. Organs recovered per donor, all organs and kidney
Figure DOD 8. Organs recovered per donor, pancreas, liver, intestine, heart, and lung
Figure DOD 9. Organs recovered per donor by DSA, 2016

Organs transplanted per donor

Figure DOD 10. Organs transplanted per donor, all organs and kidney
Figure DOD 11. Organs transplanted per donor, pancreas, liver, intestine, heart, and lung
Figure DOD 12. Organs transplanted per donor, by DSA, 2016
Figure DOD 13. Organs transplanted per donor, by DBD and DCD status
Figure DOD 14. Kidneys transplanted per donor, by DBD and DCD status
Figure DOD 15. Pancreata transplanted per donor, by DBD and DCD status
Figure DOD 16. Livers transplanted per donor, by DBD and DCD status
Figure DOD 17. Intestines transplanted per donor, by DBD and DCD status
Figure DOD 18. Hearts transplanted per donor, by DBD and DCD status
Figure DOD 19. Lungs transplanted per donor, by DBD and DCD status
Figure DOD 20. Kidneys transplanted per donor, by KDPI

Yield

Figure DOD 21. Observed-to-expected yield per kidney, 2015-2016
Figure DOD 22. Observed-to-expected yield per pancreas, 2015-2016
Figure DOD 23. Observed-to-expected yield per liver, 2015-2016
Figure DOD 24. Observed-to-expected yield per intestine, 2015-2016
Figure DOD 25. Observed-to-expected yield per heart, 2016-2016
Figure DOD 26. Observed-to-expected yield per lung, 2016-2016

Organ recovered for transplant and not transplanted

Figure DOD 27. Organs recovered for transplant and not transplanted

Organ quality

Figure DOD 28. Variation in percentage of dcd donors from all donors
Figure DOD 29. Variation in percentage of donors with KDPI greater than 85% among deceased donor kidney transplant recipients, by DSA, 2016

Organ use charts

Figure DOD 30. Organ use chart for reported left kidneys, 2016
Figure DOD 31. Organ use chart for reported right kidneys, 2016
Figure DOD 32. Organ use chart for reported en bloc kidneys, 2016
Figure DOD 33. Organ use chart for pancreas, 2016
Figure DOD 34. Organ use chart for liver, 2016
Figure DOD 35. Organ use chart for intestine, 2016
Figure DOD 36. Organ use chart for heart, 2016
Figure DOD 37. Organ use chart for lung, 2016

Table List

Donor characteristics

Table DOD 1. Characteristics of deceased donors, 2006-2016

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, 2005-2016; the imminent or eligible deaths category is NA count at 2005 and is count at 2016; the eligible deaths category is NA count at 2005 and is count at 2016; the deceased donors (dd) category increases by 31.3% from 7593 count at 2005 to 9971 count at 2016; the dd meeting eligibility criteria category is NA count at 2005 and is count at 2016; the total transplants category increases by 19.5% from 28119 count at 2005 to 33598 count at 2016; and the dd transplants category increases by 30.2% from 21213 count at 2005 to 27622 count at 2016.

Figure DOD 2. Overall counts of eligible deaths, donors, and transplants, 2005-2016
The number and source of donors with the number of transplants.


A line plot for overall counts of deceased donors, dbd donors, and dcd donors, 2005-2016; the deceased donors category increases by 31.3% from 7593 count at 2005 to 9971 count at 2016; the dbd donors category increases by 17.9% from 7029 count at 2005 to 8287 count at 2016; and the dcd donors category increases by 198.6% from 564 count at 2005 to 1684 count at 2016.

Figure DOD 3. Overall counts of deceased donors, dbd donors, and dcd donors, 2005-2016
The number of deceased donors, dbd donors and dcd donors


A line plot for overall counts of authorized and transplanted organs, 2005-2016; the organs authorized category increases by 40.9% from 50796 count of organs at 2005 to 71550 count of organs at 2016; and the organs transplanted category increases by 28.3% from 22186 count of organs at 2005 to 28456 count of organs at 2016.

Figure DOD 4. Overall counts of authorized and transplanted organs, 2005-2016
The number of authorized and recovered organs.


A map of overall donations per 100 eligible deaths by dsa, 2016, the values range from 52.93 to 93.28.

Figure DOD 5. Overall donations per 100 eligible deaths by DSA, 2016
Donation rate is the number of deceased donors meeting eligibility criteria per 100 eligible deaths. An eligible death is any hospital-reported 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, 2016, the all group is 72.29 donations per 100 eligible deaths; the kidney group is 66.65 donations per 100 eligible deaths; the pancreas group is 11.97 donations per 100 eligible deaths; the liver group is 65.70 donations per 100 eligible deaths; the heart group is 29.84 donations per 100 eligible deaths; and the lung group is 20.08 donations per 100 eligible deaths.

Figure DOD 6. Overall and organ-specific donations per 100 eligible deaths, 2016
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 organs per donor at 2005 and remains relatively constant with a value of 3.5 organs per donor at 2016; and the kidneys category is 1.8 organs per donor at 2005 and remains relatively constant with a value of 1.8 organs per donor at 2016.

Figure DOD 7. 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 48.1% from 0.3 organs per donor at 2005 to 0.1 organs per donor at 2016; the liver category is 0.9 organs per donor at 2005 and remains relatively constant with a value of 0.8 organs per donor at 2016; the intestine category decreases by 35.9% from 0 organs per donor at 2005 to 0 organs per donor at 2016; the heart category increases by 11.1% from 0.3 organs per donor at 2005 to 0.3 organs per donor at 2016; and the lung category increases by 39.2% from 0.3 organs per donor at 2005 to 0.4 organs per donor at 2016.

Figure DOD 8. 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 map of organs recovered per donor by dsa, 2016, the values range from 2.90 to 4.19.

Figure DOD 9. Organs recovered per donor by DSA, 2016
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 organs per donor at 2005 and remains relatively constant with a value of 3.1 organs per donor at 2016; and the kidneys category is 1.5 organs per donor at 2005 and remains relatively constant with a value of 1.5 organs per donor at 2016.

Figure DOD 10. 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. 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 46.4% from 0.2 organs per donor at 2005 to 0.1 organs per donor at 2016; the liver category is 0.8 organs per donor at 2005 and remains relatively constant with a value of 0.7 organs per donor at 2016; the intestine category decreases by 34.5% from 0 organs per donor at 2005 to 0 organs per donor at 2016; the heart category increases by 11.5% from 0.3 organs per donor at 2005 to 0.3 organs per donor at 2016; and the lung category increases by 35.9% from 0.3 organs per donor at 2005 to 0.4 organs per donor at 2016.

Figure DOD 11. 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. Pancreata recovered for islet transplant are excluded.


A map of organs transplanted per donor, by dsa, 2016, the values range from 2.28 to 3.80.

Figure DOD 12. Organs transplanted per donor, by DSA, 2016
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 3.2 organs per donor at 2005 and remains relatively constant with a value of 3.3 organs per donor at 2016; and the dcd category is 2 organs per donor at 2005 and remains relatively constant with a value of 1.9 organs per donor at 2016.

Figure DOD 13. 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 kidneys per donor at 2005 and remains relatively constant with a value of 1.4 kidneys per donor at 2016; and the dcd category is 1.4 kidneys per donor at 2005 and remains relatively constant with a value of 1.6 kidneys per donor at 2016.

Figure DOD 14. 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 40.3% from 0.2 pancreata per donor at 2005 to 0.1 pancreata per donor at 2016; and the dcd category decreases by 77.0% from 0.1 pancreata per donor at 2005 to 0 pancreata per donor at 2016.

Figure DOD 15. 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 livers per donor at 2005 and remains relatively constant with a value of 0.8 livers per donor at 2016; and the dcd category decreases by 44.6% from 0.5 livers per donor at 2005 to 0.3 livers per donor at 2016.

Figure DOD 16. 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 27.1% from 0 intestines per donor at 2005 to 0 intestines per donor at 2016; and the dcd category is 0 intestines per donor at 2005 and is intestines per donor at 2016.

Figure DOD 17. 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 24.2% from 0.3 hearts per donor at 2005 to 0.4 hearts per donor at 2016; and the dcd category is 0 hearts per donor at 2005 and is hearts per donor at 2016.

Figure DOD 18. 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 46.2% from 0.3 lungs per donor at 2005 to 0.5 lungs per donor at 2016; and the dcd category increases by 319.9% from 0 lungs per donor at 2005 to 0.1 lungs per donor at 2016.

Figure DOD 19. 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 kidneys per donor at 2005 and remains relatively constant with a value of 1.9 kidneys per donor at 2016; the kdpi 0.21 to 0.34 category is 1.9 kidneys per donor at 2005 and remains relatively constant with a value of 1.8 kidneys per donor at 2016; the kdpi 0.35 to 0.85 category is 1.6 kidneys per donor at 2005 and remains relatively constant with a value of 1.5 kidneys per donor at 2016; and the kdpi greater than 0.85 category decreases by 13.9% from 0.7 kidneys per donor at 2005 to 0.6 kidneys per donor at 2016.

Figure DOD 20. 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, 2015-2016, the Number of Donors ranges from 78 to 1023 with the Obs/Exp Ratio ranging from 0.90 to 1.13.

Figure DOD 21. Observed-to-expected yield per kidney, 2015-2016
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, 2015-2016, the Number of Donors ranges from 78 to 1023 with the Obs/Exp Ratio ranging from 0.14 to 2.70.

Figure DOD 22. Observed-to-expected yield per pancreas, 2015-2016
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, 2015-2016, the Number of Donors ranges from 78 to 1023 with the Obs/Exp Ratio ranging from 0.82 to 1.16.

Figure DOD 23. Observed-to-expected yield per liver, 2015-2016
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, 2015-2016, the Number of Donors ranges from 78 to 1023 with the Obs/Exp Ratio ranging from 0.00 to 4.49.

Figure DOD 24. Observed-to-expected yield per intestine, 2015-2016
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, 2016-2016, the Number of Donors ranges from 78 to 1023 with the Obs/Exp Ratio ranging from 0.68 to 1.31.

Figure DOD 25. Observed-to-expected yield per heart, 2016-2016
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, 2016-2016, the Number of Donors ranges from 78 to 1023 with the Obs/Exp Ratio ranging from 0.55 to 1.39.

Figure DOD 26. Observed-to-expected yield per lung, 2016-2016
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 is 12.7 percent at 2005 and remains relatively constant with a value of 13.7 percent at 2016; the kidney category increases by 20.6% from 16.6 percent at 2005 to 20 percent at 2016; the pancreas category is 26.3 percent at 2005 and remains relatively constant with a value of 23.8 percent at 2016; the liver category is 9.7 percent at 2005 and remains relatively constant with a value of 9.1 percent at 2016; the intestine category decreases by 26.9% from 7.1 percent at 2005 to 5.2 percent at 2016; the heart category decreases by 29.2% from 1.4 percent at 2005 to 1 percent at 2016; and the lung category increases by 83.2% from 2.8 percent at 2005 to 5.1 percent at 2016.

Figure DOD 27. Organs recovered for transplant and not transplanted
Percents 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 percentage of dcd donors from all donors, the values range from 0.00 to 37.70.

Figure DOD 28. Variation in percentage of dcd donors from all donors
Percentage of dcd donors within an DSA


A map of variation in percentage of donors with kdpi greater than 85% among deceased donor kidney transplant recipients, by dsa, 2016, the values range from 0.00 to 25.20.

Figure DOD 29. Variation in percentage of donors with KDPI greater than 85% among deceased donor kidney transplant recipients, by DSA, 2016
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 30. Organ use chart for reported left kidneys, 2016
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 31. Organ use chart for reported right kidneys, 2016
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 32. Organ use chart for reported en bloc kidneys, 2016
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 33. Organ use chart for pancreas, 2016
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 34. Organ use chart for liver, 2016
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 35. Organ use chart for intestine, 2016
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 36. Organ use chart for heart, 2016
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 37. Organ use chart for lung, 2016
A summary of the consent, recovered, tranplanted or discarded status for donated lungs.


Table DOD 1 Characteristics of deceased donors, 2006-2016
The donor characteristics of age, sex, race/ethnicity, and DCD status in 2006 and 2016.
Characteristic 2006, N 2006, Percent 2016, N 2016, Percent
Age: <18 years 969 12.1% 935 9.4%
Age: 18-34 years 2050 25.6% 3108 31.1%
Age: 35-49 years 2142 26.7% 2648 26.5%
Age: 50-64 years 2081 25.9% 2661 26.7%
Age: ≥65 years 781 9.7% 627 6.3%
Sex: Female 3239 40.4% 4019 40.3%
Sex: Male 4784 59.6% 5960 59.7%
Race/ethnicity: White 5425 67.6% 6655 66.7%
Race/ethnicity: Black 1255 15.6% 1649 16.5%
Race/ethnicity: Hispanic 1097 13.7% 1307 13.1%
Race/ethnicity: Other/unkown 246 3.1% 368 3.7%
DCD status: DBD 7486 93.3% 8481 85.0%
DCD status: DCD 537 6.7% 1498 15.0%