Analysis of outcomes and reasons for refusing organs offered by the National Transplant Center

This study analyzed 22,824 organ offers made to Brazil's National Transplant Center. Of these, 37% were accepted and 63% were refused. Among the accepted organs, 76% were transplanted. Understanding reasons for refusal may help improve national organ use and guide the developmentof effective strategies. Logistical factors were not responsible for most organ rejections in the single national waiting list. Refusal information was operator dependent, as the reason for refusal was generic in most cases. It is possible to increase the use of organs offered to the National Transplant Center by converting more offers into transplants performed through a more detailed study of the reasons for refusal. To investigate the outcomes and reasons for the refusal of organs offered on a single national list managed by the National Transplant Center. This retrospective cohort study was conducted with a quantitative approach, using data from offers of organs not used in the states and the Federal District, but offered to the National Transplant Center for national distribution. Of the 22,824 offers of unused organs in the states to the National Transplant Center, 8,483 (37%) were accepted and 14,341 (63%) refused. Of the accepted organs, 6,433 (76%) were implanted and 2,050 (24%) were not used. The use of organs at the interstate (national) level could be improved, and ascertaining the reasons for refusal could contribute to intervention strategies.