Abstract:
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The increasing shortage of organ supply has tragically meant the difference between life and death for those on transplant waiting lists. Replacing depleted hormones has been reported to increase the success of multiple organ procurements. We previously developed a method to select the optimal hormonal replacement for multiple organ procurements from brain-dead organ donors based on multiple binary endpoints; however, whether the hormone replacement is beneficial or detrimental to organ survival in recipients is unclear. Here we selected the best hormone replacement modality based on recipients' five-year graft survival using a two-step approach. First, we estimated the predicted hazards by constructing Cox proportional hazard models; then, we adapted Hsu's multiple comparisons with the best and Dunnett's multiple comparisons with control to identify the best modality. Based on 10-year data from the United Network for Organ Sharing, we found that the best hormone replacements based on graft survival were fairly consistent with those selected based on donor binary endpoints, and were beneficial or at least not detrimental to organ graft survival.
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