Many Moving Parts: New Transplant Allocation Models Are Associated With Increased Organ Travel and Potential Climate Implications

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Main Authors: Kevin Gianaris, Arrey‐Takor Paul Ayuk‐Arrey, Jonathan A. Fridell, Katherine Ross‐Driscoll
Format: Artículo Open Access
Published: Wiley 2025
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author Kevin Gianaris
Arrey‐Takor Paul Ayuk‐Arrey
Jonathan A. Fridell
Katherine Ross‐Driscoll
author_facet Kevin Gianaris
Arrey‐Takor Paul Ayuk‐Arrey
Jonathan A. Fridell
Katherine Ross‐Driscoll
Kevin Gianaris
Arrey‐Takor Paul Ayuk‐Arrey
Jonathan A. Fridell
Katherine Ross‐Driscoll
collection Wiley Open Access
contents Many Moving Parts: New Transplant Allocation Models Are Associated With Increased Organ Travel and Potential Climate Implications Kevin Gianaris Arrey‐Takor Paul Ayuk‐Arrey Jonathan A. Fridell Katherine Ross‐Driscoll Clinical Transplantation ABSTRACT Background Organ allocation has recently changed to acuity circle (AC)‐based policies. This study aimed to quantify changes in travel distance and potential environmental impacts of AC policies. Methods Data were obtained from the Scientific Registry of Transplant Recipients for each solid organ for an equidistant window before and after AC implementation. We calculated the distance between the donor and recipient hospital for each organ. We used an interrupted time series model to calculate excess travel distance after AC along with associated carbon emissions. Results We analyzed travel distance for 226 731 deceased donor organs. There was a significant increase in total excess distance traveled: 1.5 × 10 6 miles for lung, 3.1 × 10 6 for heart, 2.2 × 10 6 miles for liver, and 3.2 × 10 6 miles for kidney. This led to increased estimated carbon emissions associated with transport ranging from: 175.7 to 193.4 kg CO2e per lung, 291.7 to 312.5 kg CO2e per heart, 114.9 to 131.7 kg CO2e per liver, and 0.2 to 5.3 kg CO2e per kidney. Conclusions Our findings quantify an increase in total distance traveled and potential carbon emissions after AC implementation. Environmental impacts of allocation policies should be considered, especially with upcoming continuous distribution. 10.1111/ctr.70426 http://creativecommons.org/licenses/by/4.0/
doi_str_mv 10.1111/ctr.70426
format Artículo Open Access
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institution Wiley Open Access
license_str_mv http://creativecommons.org/licenses/by/4.0/
publishDate 2025
publisher Wiley
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spellingShingle Many Moving Parts: New Transplant Allocation Models Are Associated With Increased Organ Travel and Potential Climate Implications
Kevin Gianaris
Arrey‐Takor Paul Ayuk‐Arrey
Jonathan A. Fridell
Katherine Ross‐Driscoll
Clinical Transplantation
Many Moving Parts: New Transplant Allocation Models Are Associated With Increased Organ Travel and Potential Climate Implications Kevin Gianaris Arrey‐Takor Paul Ayuk‐Arrey Jonathan A. Fridell Katherine Ross‐Driscoll Clinical Transplantation ABSTRACT Background Organ allocation has recently changed to acuity circle (AC)‐based policies. This study aimed to quantify changes in travel distance and potential environmental impacts of AC policies. Methods Data were obtained from the Scientific Registry of Transplant Recipients for each solid organ for an equidistant window before and after AC implementation. We calculated the distance between the donor and recipient hospital for each organ. We used an interrupted time series model to calculate excess travel distance after AC along with associated carbon emissions. Results We analyzed travel distance for 226 731 deceased donor organs. There was a significant increase in total excess distance traveled: 1.5 × 10 6 miles for lung, 3.1 × 10 6 for heart, 2.2 × 10 6 miles for liver, and 3.2 × 10 6 miles for kidney. This led to increased estimated carbon emissions associated with transport ranging from: 175.7 to 193.4 kg CO2e per lung, 291.7 to 312.5 kg CO2e per heart, 114.9 to 131.7 kg CO2e per liver, and 0.2 to 5.3 kg CO2e per kidney. Conclusions Our findings quantify an increase in total distance traveled and potential carbon emissions after AC implementation. Environmental impacts of allocation policies should be considered, especially with upcoming continuous distribution. 10.1111/ctr.70426 http://creativecommons.org/licenses/by/4.0/
title Many Moving Parts: New Transplant Allocation Models Are Associated With Increased Organ Travel and Potential Climate Implications
topic Clinical Transplantation
url https://onlinelibrary.wiley.com/doi/10.1111/ctr.70426