Deceased Organ Donors

OPTN/SRTR 2019 Annual Data Report: Deceased Organ Donors

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 2019, there were 11,870 deceased donors, an increase from 10,721 in 2018; this number has been increasing since 2010. The number of deceased donor transplants increased to 32,313 in 2019, from 29,675 in 2018; this number has been increasing since 2012. The increase may be due in part to the rising number of deaths of young people due to the ongoing opioid epidemic. The number of organs transplanted included 17,425 kidneys, 1,018 pancreata, 8,275 livers, 81 intestines, 3,604 hearts, and 2,607 lungs. In 2019, 4,324 kidneys, 346 pancreata, 867 livers, 5 intestines, 31 hearts, and 148 lungs were discarded. These numbers suggest an opportunity to increase numbers of transplants by reducing discards.

Introduction

This chapter reports data collected by the Organ Procurement and Transplantation Network (OPTN) to describe changes in deceased donor characteristics over the last decade and describe deceased organ donor metrics such as donation rate, organ yield, and rate of organs recovered for transplant but not transplanted. These metrics are currently produced by the Scientific Registry of Transplant Recipients (SRTR), and some, such as organ yield, are used for organ procurement organization (OPO) quality assessment by OPTN. Some data described in this chapter are also used by the Centers for Medicare and Medicaid Services (CMS) to develop its own quality assessment of OPOs. In 2019, the federal government ordered the revision of OPO quality metrics “in order to establish more transparent, reliable, and enforceable objective metrics for evaluating an OPO’s performance.” (1) This federal order also aims to reduce organ discards nationally. CMS is also considering potential new metrics to assess OPO quality. (2) How OPTN data collection will be used to assess OPO quality remains to be seen.

Definitions of Terms Related to Deceased Organ Donation

DBD: Donations after brain death
DCD: Donations after circulatory death
Discards: Organs recovered for transplant but not transplanted
Discard Rate: Calculated by dividing the number of discards by the number of organs recovered for the purpose of transplant.
Donation rate: Number of eligible donors per 100 eligible deaths.
Donor: A person from whom at least one organ was recovered for the purpose of transplant, regardless of whether the organ was transplanted.
Eligible death: As per OPTN policy 1.2, in place before 2017, 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. On January 1, 2017, a new eligible death definition was enacted. Per this new definition, eligible death is death of a person aged 75 years or younger who is legally declared brain dead according to state or local law, has a body weight of 5 kg or more, has a body mass index of 50 kg/m² or lower, and has at least one kidney, liver, heart, or lung deemed to meet the eligible data definitions, per the new OPTN policy 1.2.
Eligible donor: A donor whose death met the definition of eligible death.
Organs authorized for recovery: Authorization 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 the donor or a surrogate donation decision maker, consistent with applicable state law.
Organs recovered per donor (ORPD): Total number of organs recovered for the purpose of transplant 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 (eg, 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.
Referrals: All deaths and imminent deaths reported to the OPO.

Donors

In 2019, 12,157 individuals met the definition of eligible death according to OPTN policy, a slight increase from 11,653 in 2018. In 2019, 20,934 imminent neurological and eligible deaths were reported, a slight decline from 21,260 in 2018, 22,260 in 2017, and 23,441 in 2016. The decline was anticipated due to changes in the OPTN definition of imminent neurological and eligible deaths (Figure DD 2) (eg, changing the absence of three brainstem reflexes to the absence of spontaneous breathing and two other brain stem reflexes). There were 11,870 deceased donors in 2019, an increase from 10,721 in 2018 and 10,286 in 2017; this number has been increasing since 2010. The number of deceased donor transplants increased to 32,313 in 2019, from 29,675 in 2018 and 28,582 in 2017; this number has been increasing since 2012. The increase may be due in part to the rising number of deaths of young people due to the ongoing opioid epidemic. In 2019, 7,391 living donor transplants (ie, difference between overall transplants and deceased donor transplants) were performed, an increase from 6843 in 2018 and 6181 in 2017; this number has been increasing since 2016 (Figure DD 2).

Donations after brain death (DBDs) increased to 9152 in 2019, from 8589 in 2018 and 8403 in 2017; this number has been increasing since 2012. Donations after circulatory death (DCDs) increased to 2718 in 2019 from 2132 in 2018 and 1883 in 2017; this number has been increasing since 2007 (Figure DD 3). Potential reasons for the increases in DBD and DCD donors include rising numbers of deaths of young people due to the opioid epidemic and increasing use of organs from DBD donors.

Donation Rate

OPTN policy 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, because successful donations can come from donors not meeting the eligible death definition (eg, DCD or donors older than 75 years). Recognizing this limitation, SRTR’s current donation rate is a measure of how often a person with an eligible death becomes a donor. In 2019, the donation rate was 71.9 eligible donors per 100 eligible deaths (Figure DD 6), an increase from 71.0 in 2018 and 69.6 in 2017. However, the 2017 changes to OPTN policy 1.2, defining eligible deaths, preclude drawing firm conclusions about differences in donation rates between 2019 and previous years. Unadjusted donation rates varied by donation service area (DSA), ranging from 56.2 to 86.8 eligible donors per 100 eligible deaths (Figure DD 5). This range is slightly narrower than the 56.2 to 90.1 observed in 2018. Risk-adjusted donation rates are presented for each OPO semi-annually in the OPO reports on the SRTR website.

As expected, donation rates varied by organ. In 2019, the highest rate was for kidneys, followed by liver, heart, lung, and pancreas. The kidney donation rate was 67.1 eligible donors per 100 eligible deaths in 2019, up from 64.9 in 2018 and 63.1 in 2017. In 2019, the next highest donation rate after kidneys was liver, at 64.6 donors per 100 eligible deaths in 2019, up from 64.1 in 2018 and 63.6 in 2017. The 2017 changes in OPTN policy 1.2, defining eligible deaths, preclude drawing firm conclusions about differences in organ-specific donation rates between 2019 and previous years (Figure DD 6).

In 2019, the lowest donation rate was 10.6 for pancreata, a slight decline from 10.7 in 2018 and 2017. In 2019, the donation rate for heart was 29.5 eligible donors per 100 eligible deaths, a slight increase from 29.4 in 2018 and 28.1 in 2017. In 2019, the donation rate for lung was 20.8 eligible donors per 100 eligible deaths, a slight increase from 20.2 in 2018 and 19.8 in 2017 (Figure DD 6).

Organs Recovered per Donor

In 2019, 3.51 organs were recovered per donor, slightly lower than the 3.53 organs in 2018 and 3.54 in 2017 (Figure DD 7). The ORPD for all organs combined has been relatively stable over the past decade (Figure DD 7, Figure DD 8). Given that each donor can potentially donate two kidneys, the ORPD was highest for kidneys, at 1.87 in 2019, followed by livers, at 0.77 in 2019 (Figure DD 7, Figure DD 8). ORPDs have remained stable for kidneys and slightly decreased for livers over the past decade. ORPDs have increased for hearts and lungs over the past decade, remained unchanged for intestines, and declined for pancreata (Figure DD 8). In 2019, the ORPD was 0.30 for heart, 0.44 for lung, 0.007 for intestine, and 0.11 for pancreata. In 2019, the ORPD varied substantially by DSA, ranging from 2.61 to 3.86, with similar breadth of range from 2.88 to 4.12 in 2018, a slightly decreased range from 2.74 to 4.15 in 2017 (Figure DD 9). The ORPD is an unadjusted number and thus represents a mix of donor types, including young, old, DBDs, and DCDs, which explains some differences observed.

Organs Transplanted per Donor and Organ Yield

The number of OTPDs was 3.01 in 2019, slightly down from 3.06 in 2018 and 3.07 in 2017 (Figure DD 10). Given that each donor can potentially donate two kidneys, the OTPD was highest for kidneys, followed by livers (Figure DD 10, Figure DD 11). OTPD increased for lungs over the past decade but declined for pancreata (Figure DD 11). In 2019, the OTPD for individual organs was 1.49 for kidney, 0.69 for liver, 0.41 for lung, 0.30 for heart, 0.08 for pancreas, and 0.006 for intestine.

Numbers of deceased donor organs transplanted in 2019 were 17,746 kidneys (8601 left kidneys, 8503 right kidneys, and 321 en bloc kidneys), 1,018 pancreas, 8275 livers, 81 intestines, 3604 hearts, and 2607 lungs (Figure DD 30-37). In contrast, the numbers of deceased donor organs transplanted in 2018 were 15,877 kidneys, 1029 pancreata, 7766 livers, 106 intestines, 3443 hearts, and 4542 lungs. In a 2019 unadjusted analysis, not accounting for the mix of DBD and DCD donor types, OTPD varied substantially by DSA, ranging from 2.08 to 3.60, a wider range than the 2.26 to 3.56 in 2018 (Figure DD 12).

The OTPD from DBD donors was 3.33 in 2019, slightly down from 3.34 in 2018 and 3.33 in 2017. The OTPD from DCD donors was 1.94 in 2019, same as the 1.94 in 2018, and slightly down from 1.92 in 2017 (Figure DD 13).

In 2019, average numbers of kidneys transplanted per donor were 1.48 DBD and 1.55 DCD (Figure DD 14). In 2018, average numbers of kidneys transplanted per donor were 1.46 DBD (12,524 kidneys) and 1.57 DCD (3357 kidneys). Thus, the number of kidneys transplanted per donor for DCD has continued to increase since 2014 (Figure DD 14).

Apart from kidney donors, OTPD was higher from DBD than from DCD donors (Figure DD 14, Figure DD 15, Figure DD 16, Figure DD 17, Figure DD 18, Figure DD 19). The OTPD for kidneys has been higher from DCD than from DBD donors since 2006 (Figure DD 14). Compared with 2018, the number of DCD liver transplants per donor increased slightly in 2019, while DBD liver transplants per donor decreased slightly in 2019 (Figure DD 16). Throughout the last decade, the number of DCD and DBD liver transplants per donor has remained stable (Figure DD 16). For intestine and pancreas transplants, DBD transplants per donor have continued to decline over the last decade (Figure DD 15, Figure DD 17). In contrast, for heart and lung transplants, DBD transplants per donor have continued to increase over the last decade.

In 2019, among kidney donors, OTPD varied by kidney donor profile index (KDPI), at 1.93, 1.85, 1.57, and 0.65 for KDPI <0.20, 0.21-0.34, 0.35-0.85, and >0.85, respectively (Figure DD 20). The number of kidneys transplanted has increased slightly for KDPI >0.34 each year since 2016. In 2018, among kidney donors, OPTD was 1.95, 1.86, 1.57, and 0.64; in 2017, OTPD was 1.93, 1.87, 1.55, and 0.63 for KDPI <0.20, 0.21-0.34, 0.35-0.85, and >0.85, respectively (Figure DD 20).

The yield metric shown in Figure DD 21, Figure DD 22, Figure DD 23, Figure DD 24, Figure DD 25, and Figure DD 26 compares the number of organs transplanted (observed) in 2018-2019 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 less than 1 indicates that fewer organs were transplanted than would be expected based on national models for that organ. A ratio of more than 1 indicates that more organs were transplanted than would be expected. In 2019, the mean observed/expected ratio for all organs ranged from 0.90 to 1.11; it ranged from 0.87 to 1.08 for kidneys, 0.37 to 2.21 for pancreata, 0.76 to 1.17 for livers, 0.00 to 4.24 for intestines, 0.82 to 1.25 for hearts, and 0.61 to 1.55 for lungs. In 2018, the mean observed/expected ratio had similar ranges and for all organs ranged from 0.86 to 1.05; it ranged from 0.90 to 1.07 for kidneys, 0.30 to 2.43 for pancreata, 0.77 to 1.14 for livers, 0 to 4.30 for intestines, 0.83 to 1.29 for hearts, and 0.43 to 1.96 for lungs.

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 2019 for all organs combined was 14.3 per recovered organ, higher than 13.2 in 2018 and 2017 (Figure DD 27). In 2019, 5957 organs were discarded, much higher than 4994 in 2018 and 4813 in 2017. This trend in increasing number of annual discards has persisted since 2017. In 2019, 4460 kidneys, 345 pancreata, 874 livers, 5 intestines, 31 hearts, and 338 lungs were discarded. In 2018, 3755 kidneys, 278 pancreata, 707 livers, 3 intestines, 23 hearts, and 317 lungs were discarded. Thus, the number of discards for each organ has increased from 2018 for all organs. (Figure DD 27).

Use of DCD Organs and High KDPI Kidneys

Use of DCD organs varied across OPOs, from 0% to 45% of all deceased donors, in 2019 (Figure DD 28). In 2018, the percentage of DCD donor organs among deceased donor transplant recipients varied across DSAs, from 0.0 to 50.9, a broader range than in 2019. In 2019, the percentage of kidney donors with KDPI higher than 85% also varied across DSAs, ranging from 0 to 16.8, a narrower range than 0 to 19.7 in 2018 and 0 to 29.9 in 2017 (Figure DD 29).

Disposition of Organs

The disposition of each organ from actual donors is described in Figure DD 30, Figure DD 31, Figure DD 32, Figure DD 33, Figure DD 34, Figure DD 35, Figure DD 36, and Figure DD 37. For kidneys, the most common reason for discard was “no recipient located, list exhausted,” followed by “biopsy findings.” For pancreas, the most common reasons for discard were “other” and “anatomical abnormalities.” For livers, the most common reason for discards was “biopsy findings,” followed by “other, specify.” The most common reasons for the 5 intestines discarded were “recipient determined to be unsuitable for transplantation in the operating room” and “other, specify.” For hearts, the most common reason was “other, specify.” For lungs, the most common reason was “other, specify” and “poor organ function.” Donor characteristics from 2019 are compared with characteristics in 2009 in Table DD 1. The most remarkable difference was the increase in HIV-positive donors to 21 in 2019 from none in 2009. This increase is due to the HIV Organ Policy Equity (HOPE) Act, enacted in 2013, which modified rules about organ donation between HIV-positive individuals and authorized use of these organs as part of clinical research. Other remarkable differences were an increase in anoxia as cause of donor death, from 23.6% in 2009 to 45.0% in 2019, and decreases in stroke (39.6% to 26.3%) and head trauma (33.3% to 25.4%). The percentage of DCD donors increased from 11.5% in 2009 to 22.9% in 2019. The increases in numbers of donors aged 18-49 years (4108 to 6664), and the increase in number with anoxia as cause of death (1893 to 5346), may reflect increased deaths due to the opioid abuse epidemic. Among donors with anoxia as cause of death, there was over a 3-fold increase in donors aged 18-64 years (Table DD 2). Among donors who died of stroke, head trauma, CNS tumor, and other or unknown cause, the number of deaths and aged distribution of donors was more similar in 2009 and 2019 (Table DD 3, Table DD 4, Table DD 5, Table DD 6).

References

Trump DJ. Executive Order on Advancing American Kidney Health 2019, issued 2019 July 10. Available at https://www.whitehouse.gov/presidential-actions/executive-order-advancing-american-kidney-health.
Department of Health and Human Services, 2019, no. 7806.

Figure List

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Table List

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Table DD 1. Characteristics of deceased donors, 2009 and 2019
Table DD 2. Characteristics of deceased donors whose cause of death was anoxia, 2009 and 2019
Table DD 3. Characteristics of deceased donors whose cause of death was stroke, 2009 and 2019
Table DD 4. Characteristics of deceased donors whose cause of death was CNS tumor, 2009 and 2019
Table DD 5. Characteristics of deceased donors whose cause of death was head trauma, 2009 and 2019
Table DD 6. Characteristics of deceased donors whose cause of death was other or unknown, 2009 and 2019

**Figure DD 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.

**Figure DD 2. Overall counts of eligible deaths, donors, and transplants, 2008-2019**
The number and source of donors with the number of transplants.

**Figure DD 3. Overall counts of deceased donors, DBD donors, and DCD donors, 2008-2019**
The number of deceased donors, DBD donors and DCD donors. Deceased donor counts include all donors for whom at least one organ was recovered for transplant. DBD, donation after brain death; DCD, donation after circulatory death.

**Figure DD 4. Overall counts of authorized, recovered and transplanted organs, 2008-2019**
The number of authorized , recovered, and transplanted organs.

**Figure DD 5. Eligible Donors per 100 eligible deaths by DSA, 2019**
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.

**Figure DD 6. Overall and organ-specific eligible donors per 100 eligible deaths, 2019**
Organ-specific rates represent the number of donors of each organ type meeting eligibility criteria per 100 eligible deaths.

**Figure DD 7. Organs recovered per donor, all organs and kidney, 2019**
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.

**Figure DD 8. Organs recovered per donor, pancreas, liver, intestine, heart, and lung, 2019**
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.

**Figure DD 9. Organs recovered per donor by DSA, 2019**
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.

**Figure DD 10. Organs transplanted per donor, all organs and kidney, 2008 - 2019**
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.

**Figure DD 11. Organs transplanted per donor, pancreas, liver, intestine, heart, and lung, 2008 - 2019**
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.

**Figure DD 12. Organs transplanted per donor, by DSA, 2019**
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.

**Figure DD 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. DBD, donation after brain death; DCD, donation after circulatory death.

**Figure DD 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. DBD, donation after brain death; DCD, donation after circulatory death.

**Figure DD 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. DBD, donation after brain death; DCD, donation after circulatory death.

**Figure DD 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. DBD, donation after brain death; DCD, donation after circulatory death.

**Figure DD 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. DBD, donation after brain death; DCD, donation after circulatory death.

**Figure DD 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. DBD, donation after brain death; DCD, donation after circulatory death.

Figure DD 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.

**Figure DD 21. Observed-to-expected yield per kidney, 2018-2019**
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.

**Figure DD 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.

**Figure DD 28. Variation in percentage of DCD donors from all donors, 2019**
Percentage of DCD donors within an DSA.

**Figure DD 29. Variation in percentage of kidney donors with KDPI greater than 85% among deceased donor kidney transplant recipients, by DSA, 2019**
Percentage of deceased donor transplants within a DSA with KDPI greater than 85%.

**Figure DD 30. Organ use chart for reported left kidneys, 2019**
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. "Local" transplant or discard occurred within the Donation Service Area of the donor organ, and "shared" occurred outside the DSA.

**Figure DD 31. Organ use chart for reported right kidneys, 2019**
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. "Local" transplant or discard occurred within the Donation Service Area of the donor organ, and "shared" occurred outside the DSA.

**Figure DD 32. Organ use chart for reported en bloc kidneys, 2019**
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. "Local" transplant or discard occurred within the Donation Service Area of the donor organ, and "shared" occurred outside the DSA.

**Figure DD 33. Organ use chart for pancreas, 2019**
A summary of the consent, recovered, tranplanted or discarded status for donated pancreas. "Local" transplant or discard occurred within the Donation Service Area of the donor organ, and "shared" occurred outside the DSA.

**Figure DD 34. Organ use chart for liver, 2019**
A summary of the consent, recovered, tranplanted or discarded status for donated livers. "Local" transplant or discard occurred within the Donation Service Area of the donor organ, and "shared" occurred outside the DSA.

**Figure DD 35. Organ use chart for intestine, 2019**
A summary of the consent, recovered, tranplanted or discarded status for donated intestines. "Local" transplant or discard occurred within the Donation Service Area of the donor organ, and "shared" occurred outside the DSA.

**Figure DD 36. Organ use chart for heart, 2019**
A summary of the consent, recovered, tranplanted or discarded status for donated hearts. "Local" transplant or discard occurred within the Donation Service Area of the donor organ, and "shared" occurred outside the DSA.

**Figure DD 37. Organ use chart for lung, 2019**
A summary of the consent, recovered, tranplanted or discarded status for donated lungs. "Local" transplant or discard occurred within the Donation Service Area of the donor organ, and "shared" occurred outside the DSA.

**Table DD 1. Characteristics of deceased donors, 2009 and 2019**
Note: The way citizenship data is collected changed in 2012, so differences may be misleading.
Characteristic	2009, N	2009, Percent	2019, N	2019, Percent
KDPI: 0-≤20%	1654	20.6%	2151	18.1%
KDPI: >20-<35%	894	11.1%	1506	12.7%
KDPI: 35-≤85%	3589	44.7%	5547	46.7%
KDPI: >85-100%	1491	18.6%	1996	16.8%
KDPI: Unknown/missing	394	4.9%	670	5.6%
HIV: Not Positive			11,849	99.8%
HIV: Positive			21	0.2%
HCV: Not Positive	7674	95.7%	11,091	93.4%
HCV: Positive	348	4.3%	779	6.6%
Citizenship: US	7900	98.5%	10,330	87.0%
Citizenship: Non-US	2	0.0%	376	3.2%
Citizenship: Other/unkown	120	1.5%	1164	9.8%
COD: Anoxia	1893	23.6%	5346	45.0%
COD: Stroke	3178	39.6%	3122	26.3%
COD: Head Trauma	2671	33.3%	3011	25.4%
COD: CNS Tumor	43	0.5%	41	0.3%
COD: Other/unkown	237	3.0%	350	2.9%
Sex: Female	3295	41.1%	4706	39.6%
Sex: Male	4727	58.9%	7164	60.4%
Age: <18 years	912	11.4%	917	7.7%
Age: 18-34 years	2002	25.0%	3296	27.8%
Age: 35-49 years	2106	26.3%	3348	28.2%
Age: 50-64 years	2310	28.8%	3454	29.1%
Age: ≥65 years	692	8.6%	855	7.2%
Ethnicity: Non-Latino/unkown	6913	86.2%	10,055	84.7%
Ethnicity: Latino	1109	13.8%	1815	15.3%
Race: White	6464	80.6%	9553	80.5%
Race: Black	1311	16.3%	1828	15.4%
Race: Asian	192	2.4%	318	2.7%
Race: Other/unkown	55	0.7%	171	1.4%
DCD status: DBD	7102	88.5%	9152	77.1%
DCD status: DCD	920	11.5%	2718	22.9%

**Table DD 2. Characteristics of deceased donors whose cause of death was anoxia, 2009 and 2019**
Demographics as reported to the OPTN.
Characteristic	2009, N	2009, Percent	2019, N	2019, Percent
Race: White	1575	83.2%	4403	82.4%
Race: Black	270	14.3%	783	14.6%
Race: Asian	29	1.5%	90	1.7%
Race: Other/unkown	19	1.0%	70	1.3%
Sex: Female	880	46.5%	2254	42.2%
Sex: Male	1013	53.5%	3092	57.8%
Age: <18 years	323	17.1%	476	8.9%
Age: 18-34 years	525	27.7%	1619	30.3%
Age: 35-49 years	507	26.8%	1611	30.1%
Age: 50-64 years	454	24.0%	1406	26.3%
Age: ≥65 years	84	4.4%	234	4.4%

**Table DD 3. Characteristics of deceased donors whose cause of death was stroke, 2009 and 2019**
Demographics as reported to the OPTN.
Characteristic	2009, N	2009, Percent	2019, N	2019, Percent
Race: White	2415	76.0%	2344	75.1%
Race: Black	632	19.9%	581	18.6%
Race: Asian	117	3.7%	156	5.0%
Race: Other/unkown	14	0.4%	41	1.3%
Sex: Female	1599	50.3%	1526	48.9%
Sex: Male	1579	49.7%	1596	51.1%
Age: <18 years	56	1.8%	47	1.5%
Age: 18-34 years	246	7.7%	294	9.4%
Age: 35-49 years	956	30.1%	919	29.4%
Age: 50-64 years	1402	44.1%	1383	44.3%
Age: ≥65 years	518	16.3%	479	15.3%

**Table DD 4. Characteristics of deceased donors whose cause of death was CNS tumor, 2009 and 2019**
Demographics as reported to the OPTN.
Characteristic	2009, N	2009, Percent	2019, N	2019, Percent
Race: White	35	81.4%	35	85.4%
Race: Black	6	14.0%	4	9.8%
Race: Asian	1	2.3%	1	2.4%
Race: Other/unkown	1	2.3%	1	2.4%
Sex: Female	28	65.1%	24	58.5%
Sex: Male	15	34.9%	17	41.5%
Age: <18 years	7	16.3%	3	7.3%
Age: 18-34 years	10	23.3%	8	19.5%
Age: 35-49 years	17	39.5%	21	51.2%
Age: 50-64 years	8	18.6%	7	17.1%
Age: ≥65 years	1	2.3%	2	4.9%

**Table DD 5. Characteristics of deceased donors whose cause of death was head trauma, 2009 and 2019**
Demographics as reported to the OPTN.
Characteristic	2009, N	2009, Percent	2019, N	2019, Percent
Race: White	2240	83.9%	2485	82.5%
Race: Black	372	13.9%	416	13.8%
Race: Asian	39	1.5%	60	2.0%
Race: Other/unkown	20	0.7%	50	1.7%
Sex: Female	690	25.8%	752	25.0%
Sex: Male	1981	74.2%	2259	75.0%
Age: <18 years	474	17.7%	358	11.9%
Age: 18-34 years	1155	43.2%	1286	42.7%
Age: 35-49 years	560	21.0%	692	23.0%
Age: 50-64 years	400	15.0%	543	18.0%
Age: ≥65 years	82	3.1%	132	4.4%

**Table DD 6. Characteristics of deceased donors whose cause of death was other or unknown, 2009 and 2019**
Demographics as reported to the OPTN. Other or unknown cause of death includes all causes other than anoxia, stroke, CNS tumor, or head trauma.
Characteristic	2009, N	2009, Percent	2019, N	2019, Percent
Race: White	199	84.0%	286	81.7%
Race: Black	31	13.1%	44	12.6%
Race: Asian	6	2.5%	11	3.1%
Race: Other/unkown	1	0.4%	9	2.6%
Sex: Female	98	41.4%	150	42.9%
Sex: Male	139	58.6%	200	57.1%
Age: <18 years	52	21.9%	33	9.4%
Age: 18-34 years	66	27.8%	89	25.4%
Age: 35-49 years	66	27.8%	105	30.0%
Age: 50-64 years	46	19.4%	115	32.9%
Age: ≥65 years	7	3.0%	8	2.3%