Drowned Kidney and Liver Donors Demonstrate No Difference in Mortality and Graft Failure Compared With the 4 Most Common Extrinsic Causes of Donor Deaths.

Objectives: The risks of mortality and graft failure in those receiving organ transplants from donors who have drowned are unclear. We compared 5-year mortality and graft survival from those receiving a drowned donor kidney or liver to those receiving organs from alternative causes of nondrowning donor death.

Materials And Methods: In this retrospective analysis, we searched the United Network for Organ Sharing database between January 1, 2010, and June 30, 2022. Pediatric donors and recipients and multiple-organ transplants were excluded. Subjects were sorted into causes of death by drowning, gunshot, drug intoxication, aspiration, and blunt injury. We used analysis of variance tests for continuous variables and chi-square or Fischer exact tests for categorical variables, depending on sample size and distribution of the variables included. Survival curves and estimates for the outcomes were obtained with the Kaplan-Meier product limit method. In survival analyses of transplant outcomes, death (for recipient survival) or graft failure (for graft survival) were the endpoints. We used multivariable Cox regression to adjust for covariates.

Results: No significant differences were shown in graft failure (P = .584, P = .990, P = .878, P = .816) or mortality rates (P = .374, P = .297, P = .217, P = .210) up to 5 years after transplant for recipients of kidneys from drowned donors. The same comparisons among recipients of livers from drowned donors yielded no significant difference in graftfailure (P = .991, P = .376, P = .639, P = .937) or mortality (P = .970, P = .863, P = .966, P = .899).

Conclusions: Transplant institutions should consider including drowned donors in their expanded criteria as we found no significant difference in graftfailure or mortality in both kidney and liver recipients.