AUTHOR=Chotkan K. A. , Kuiper M. A. , Alwayn I. P. J. , Heemskerk M. B. A. , Braat A. E. , Jansen N. E. 

TITLE=Analysis of Unused Organ Donors in the Netherlands: Older Donor Age Associated With Higher Risk of Non-Utilization

JOURNAL=Transplant International

VOLUME=Volume 38 - 2025

YEAR=2025

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2025.14157

DOI=10.3389/ti.2025.14157

ISSN=1432-2277

ABSTRACT=This study aims to objectify the subjectively observed increase of non-utilized donors and investigate whether they have common risk factors, hypothesizing that aging of the donor population could be a possible explanation.All referred deceased donors in the Netherlands between 2018 -2023 were analyzed. A utilized donor was defined as a referred donor resulting in at least one transplanted organ. A non-utilized donor was defined as a donor from whom no organ was transplanted, due to the cessation.In total, 2235 donors were referred; 1618 donors were utilized and 617 non-utilized. A significant increase in reported donors aged >66 years was seen, together with an increase of non-utilized donors of 51%. The most frequent reasons for not utilizing a donor are an agonal phase > two hours in DCD donors (45%) and an unacceptable medical history during screening (22%). Multivariable logistic regression analysis showed that increasing donor age (age 66-75 years OR 1.81, 95% CI 1.09-3.00), DCD-donors (OR 4.37 95% CI 3.24-5.89, p<0.01), history of hypertension (OR 1.29 95% CI 1.01-1.66, p=0.04) and/or diabetes  p<0.01) are associated with non-utilization.Non-utilized donors are significantly older, are more often DCD-donors and have more comorbidities, confirming the hypothesis that these donors are the more marginal donors.