What is it about?
This study explores how medical quality measures and transportation conditions influence the likelihood of discarding deceased-donor kidneys. While previous research emphasized clinical factors, we also examine how distance, airport access, and timing affect organ disposal. We examined a dataset monitoring deceased-donor kidneys in UNOS Region 4 from 2001 to 2021, employing binary logistic regression and pooled logit models to accommodate temporal variation. We focused on key medical indicators, such as the Kidney Donor Profile Index (KDPI) and cold ischemia time (CIT), as well as logistical factors, including distance to transplant centers, airport type, time of day, and day of the week. Our results, presented in an easily understandable format, highlight how these factors impact organ discard rates. Our findings show that higher KDPI and longer CIT increase the likelihood of discarding. Logistical factors such as distance to the transplant center and airport type also play significant roles, with organs from smaller or non-hub airports experiencing higher discard rates. We noted some system shifts over the years, though time of day and day of the week appeared less influential. Additionally, our analysis suggests that logistical challenges disproportionately impact marginal-quality organs. This study uniquely combines clinical risk factors and transportation issues, providing helpful suggestions for improving allocation systems, transport logistics, and infrastructure planning. Our findings enhance healthcare supply chain theory by demonstrating how accessibility and coordination significantly affect medical resource utilization in this critical area.
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Why is it important?
This study is important because it shows that kidney discard is not driven solely by medical risk but also by transportation and accessibility constraints, revealing that improving logistics systems can directly increase organ utilization and save lives.
Perspectives
From a personal perspective, this research highlights that life-saving organs are sometimes lost due to logistics rather than medical limitations. This is especially important because logistics is a solvable problem—improving transportation and coordination can directly increase transplant success and save lives.
Dr. Seock-Jin Hong
Read the Original
This page is a summary of: Logistics accessibility and medical risk in deceased-donor kidney discard: an empirical healthcare supply chain analysis, The International Journal of Logistics Management, April 2026, Emerald,
DOI: 10.1108/ijlm-04-2025-0294.
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