The Reward is Worth the Wait: A Prospective Analysis of 100 Consecutive Organ Donors

2012 ◽  
Vol 78 (3) ◽  
pp. 296-299 ◽  
Author(s):  
A. Britton Christmas ◽  
Tyson A. Bogart ◽  
Kristina E. Etson ◽  
Brett A. Fair ◽  
Harold R. Howe ◽  
...  
Keyword(s):  
Patient Management ◽  
Organ Procurement ◽  
Prospective Analysis ◽  
Organ Donors ◽  
Donor Management ◽  
Organ Procurement Organization ◽  
Patient Demographics ◽  
Included Patient ◽  
Initial Hypothesis

Aggressive donor management protocols have evolved to maximize the number of procured organs. Our study assessed donor management time and the number and types of organs procured with the hypothesis that shorter management time yields increased organ procurement and transplant rates. We prospectively analyzed 100 donors managed by a regional organ procurement organization (OPO) during 2007 to 2008. Data included patient demographics, number and types of organs procured and transplanted, patient management time by the OPO, and achievement of donor pre-procurement goals. One hundred consecutive organ donors were managed with a mean age 41 ± 18 years and mean management time 23 ± 9 hours; 376 organs were procured and 327 successfully transplanted. Donors managed greater than 20 hours yielded significantly more heart (5 vs 26, P < 0.01) and lung (6 vs 40, P < 0.01) procurements, more organs procured per donor (3.2 ± 1.4 vs 4.2 ± 1.6, P < 0.01), and more organs transplanted per donor (2.6 ± 1.5 vs 3.7 ± 1.8, P < 0.01) than those managed 20 hours or less. No difference in the attainment of donor management goals was observed between these populations. Contrary to our initial hypothesis, donor management times greater than 20 hours yielded increased organ procurement and transplant rates, particularly for hearts and lungs, despite no differences in the achievement of donor preprocurement management goals.

An In-House Coordinator Program to Increase Organ Donation in Public Trauma Hospitals

1998 ◽  
Vol 8 (2) ◽  
pp. 82-87 ◽  
Author(s):  
Teresa Shafer ◽  
R. Patrick Wood ◽  
Charles Van Buren ◽  
William Guerriero ◽  
Kimberly Davis ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Organ Donation ◽  
Organ Procurement ◽  
Consent Process ◽  
Organ Donors ◽  
Consent Rate ◽  
Donor Management ◽  
Organ Procurement Organization ◽  
Conversion Rates ◽  
Organ Recovery

A 4-year retrospective study was conducted regarding the donor potential, consent rates, and organ recovery at a large 500-bed public trauma hospital. An independent organ procurement organization hired two in-house coordinators, one white and one black, to work exclusively in the hospital. The duties of the in-house coordinators included the following: working with nurses, physicians, and residents to identify donors; closely managing and coordinating the consent process; and assisting organ procurement coordinators in donor management. Following the program's implementation and the use of race-specific requesters, a 64% increase in consent rate resulted along with an overall increase of 94% in the number of organ donors. The consent rate of blacks increased 115%, whereas the number of black organ donors increased 154%. The Hispanic consent rate increased 48% with a corresponding increase of 83% in the number of Hispanic organ donors. In addition, the white consent rate increased from 55% (the 3-year average from 1993 to 1995) to 75% in 1996, resulting in a 36% increase following the implementation of the program. The investment of dedicated race-sensitive personnel in large urban county trauma facilities can result in a significant increase in donor conversion rates.

Point-of-care testing in an organ procurement organization donor management setting

2003 ◽  
Vol 17 ◽  
pp. 48-51 ◽  
Author(s):  
K A Baier ◽  
L E Markham ◽  
S P Flaigle ◽  
P W Nelson ◽  
C F Shield ◽  
...  
Keyword(s):  
Organ Procurement ◽  
Point Of Care ◽  
Point Of Care Testing ◽  
Donor Management ◽  
Organ Procurement Organization

scholarly journals LO66: Solid organ donation from the emergency department: A death review

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S31-S32
Author(s):  
J. McCallum ◽  
R. Yip ◽  
S. Dhanani ◽  
I. Stiell
Keyword(s):  
Emergency Department ◽  
Organ Donation ◽  
Primary Outcome ◽  
Organ Procurement ◽  
Care Center ◽  
Demographic Data ◽  
Tertiary Care ◽  
Solid Organ ◽  
Organ Donors ◽  
Organ Procurement Organization

Introduction: A significant gap exists between the number of people waiting for an organ and donors. There are currently 1,628 people awaiting organ donation in Ontario alone. In 2018 to date, 310 donors have donated 858 organs. The purpose of this study was to determine whether there were missed donors in the Emergency Department (ED) and by what percent those missed donors would increase organ donation overall. Methods: This was a health records and organ donation database review of all patients who died in the ED at a large academic tertiary care center with 2 campuses and 160,000 visits per year. Patients were included from November 1, 2014 – October 31, 2017. We collected data on demographics, cause of death, and suitability for organ donation. Data was cross-referenced between hospital records and the provincial organ procurement organization called Trillium Gift of Life Network (TGLN) to determine whether patients were appropriately referred for consideration of donation in a timely manner. Potential missed donors were manually screened for suitability according to TGLN criteria. We calculated simple descriptive statistics for demographic data and the primary outcome. The primary outcome was percentage of potential organ donors missed in the Emergency Department (ED). Results: There were 606 deaths in the ED from November 1, 2014 – October 31, 2017. Patients were an average of 71 years old, 353 (58%) were male, and 75 (12%) died of a traumatic cause. TGLN was not contacted in 12 (2%) of cases. During this period there were two donors from the ED and 92 from the ICU. There were ten missed potential donors. They were an average of 67 years, 7 (70%) were male, and 2 (20%) died of a traumatic cause. In all ten cases, patients had withdrawal of life sustaining measures for medical futility prior to TGLN being contacted for consideration of donation. There could have been an addition seven liver, six pancreatic islet, four small bowel, and seven kidney donors. The ten missed ED donors could have increased total donors by 11%. Conclusion: The ED is a significant source of missed organ donors. In all cases of missed organ donation, patients had withdrawal of life sustaining measures prior to TGLN being called. In the future, it is essential that all patients have an organ procurement organization such as TGLN called prior to withdrawal of life sustaining measures to ensure that no opportunity for consideration of organ donation is missed.

scholarly journals A multicenter randomized placebo-controlled trial of intravenous thyroxine for heart-eligible brain-dead organ donors

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Rajat Dhar ◽  
Dean Klinkenberg ◽  
Gary Marklin
Keyword(s):  
Thyroid Hormone ◽  
Organ Procurement ◽  
Hemodynamic Instability ◽  
Controlled Study ◽  
Primary Study ◽  
Organ Donors ◽  
Donor Management ◽  
Link Type ◽  
Thyroxine Treatment ◽  
Brain Dead

Abstract Background Brain death frequently induces hemodynamic instability and cardiac stunning. Impairments in cardiac performance are major contributors to hearts from otherwise eligible organ donors not being transplanted. Deficiencies in pituitary hormones (including thyroid-stimulating hormone) may contribute to hemodynamic instability, and replacement of thyroid hormone has been proposed as a means of improving stability and increasing hearts available for transplantation. Intravenous thyroxine is commonly used in donor management. However, small controlled trials have not been able to demonstrate efficacy. Methods This multicenter study will involve organ procurement organizations (OPOs) across the country. A total of 800 heart-eligible brain-dead organ donors who require vasopressor support will be randomly assigned to intravenous thyroxine for at least 12 h or saline placebo. The primary study hypotheses are that thyroxine treatment will result in a higher proportion of hearts transplanted and that these hearts will have non-inferior function to hearts not treated with thyroxine. Additional outcome measures are the time to achieve hemodynamic stability (weaning off vasopressors) and improvement in cardiac ejection fraction on echocardiography. Discussion This will be the largest randomized controlled study to evaluate the efficacy of thyroid hormone treatment in organ donor management. By collaborating across multiple OPOs, it will be able to enroll an adequate number of donors and be powered to definitively answer the critical question of whether intravenous thyroxine treatment increases hearts transplanted and/or provides hemodynamic benefits for donor management. Trial registration ClinicalTrials.govNCT04415658. Registered on June 4, 2020

Screening Deceased Organ Donors for Syphilis: A Survey of Organ Procurement Organization Practices

2012 ◽  
Vol 94 (10S) ◽  
pp. 544
Author(s):  
N. Theodoropoulos ◽  
A. Jaramillo ◽  
D. P. Ladner ◽  
M. G. Ison
Keyword(s):  
Organ Procurement ◽  
Organ Donors ◽  
Organ Procurement Organization

Testing deceased organ donors for infections: An organ procurement organization survey

2021 ◽  
Author(s):  
Nicole M. Theodoropoulos ◽  
Melissa Greenwald ◽  
Peter Chin‐Hong ◽  
Michael G. Ison
Keyword(s):  
Organ Procurement ◽  
Organ Donors ◽  
Organ Procurement Organization

Evaluation of a Small Organ Procurement Organization in the Basque Country, Spain

1996 ◽  
Vol 6 (4) ◽  
pp. 167-170 ◽  
Author(s):  
Jon Darpon ◽  
Javier Arrieta ◽  
Pilar Elorrieta ◽  
Pilar Olaizola ◽  
Rosa Lavari ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Organ Procurement ◽  
Basque Country ◽  
Organ Donors ◽  
Organ Procurement Organization ◽  
Main Obstacle ◽  
Limited Supply ◽  
Cadaveric Organ ◽  
Cadaveric Kidney ◽  
Coordination Team

A limited supply of organs is the main obstacle for organ transplantation. The shortage reflects not only a shortage of donors but also a failure to make use of existing donors. The Basque Country Transplant Coordination Team is an organ procurement organization that operates in the Basque country, an area of 7260 km2 with 2.1 million inhabitants. From January 1, 1990, to December 31, 1995, the number of potential cadaveric organ donors found by the team increased, to 70 donors per million inhabitants in 1995. Since 1993, the organization has had more than 30 donors per million persons and has procured more than 90 cadaveric organs, including more than 60 cadaveric kidneys, per million persons. Because of these rates, the team coordinated 61.7 cadaveric kidney transplants per million persons during 1995. This paper describes some characteristics of the Basque organ procurement organization that might explain these results.

Pediatric Donor Management Goals in Use by US Organ Procurement Organizations

2019 ◽  
Vol 29 (2) ◽  
pp. 150-156
Author(s):  
Robert S. Ream ◽  
Matthew G. Clark ◽  
Eric S. Armbrecht
Keyword(s):  
Serum Creatinine ◽  
Organ Procurement ◽  
Venous Pressure ◽  
Serum Glucose ◽  
Arterial Oxygen ◽  
Organ Donors ◽  
Donor Management ◽  
Organ Procurement Organizations ◽  
Pediatric Donors

Introduction: A recent study of pediatric organ donation after the neurologic determination of death (DNDD) demonstrated an association between the use of donor management goals (DMGs) by organ procurement organizations (OPOs) and organ yield. Objective: To describe the pediatric DMGs used by OPOs and any association between specific DMGs and organ yield. Design: Query of US OPOs who utilized DMGs in the care of pediatric DNDD organ donors from 2010 to 2013. Results: All 23 OPOs using DMGs for pediatric DNDD organ donors during the study period participated (100%). The OPOs pursued an average 9.6 goals (standard deviation: 3.9; range: 5-22) with 113 unique definitions that targeted 33 aspects of donor hemodynamics, gas exchange/mechanical ventilation, electrolytes/renal function, blood products, thermoregulation, and infection control. The DMGs used by >50% of OPOs included blood pressure, oxygenation (partial pressure of arterial oxygen (PaO2), oxygen saturation of hemoglobin by pulse oximetry, or PaO2/fractional concentration of inspired oxygen [FiO2] ratio), pH, central venous pressure, serum sodium, urine output, limitations on inotropic support, and serum glucose. There was no significant correlation between the number of DMGs pursued by OPOs and organ yield. There was a difference in the observed/expected organs transplanted in the 0- to 10-year age-group for OPOs that included serum creatinine among their DMGs ( P = .046). Conclusions: The pediatric DMGs used by OPOs were generally measurable but diverse in definition and the number of goals pursued. There was no benefit in organ yield from larger DMG bundles. There may be a benefit in organ yield through the use of serum creatinine as a DMG in pediatric donors aged 0 to 10 years.

Hospital Characteristics Affect Consent and Conversion Rates for Potential Organ Donors

2017 ◽  
Vol 83 (4) ◽  
pp. 354-358
Author(s):  
Jawad T. Ali ◽  
Aileen Ebadat ◽  
Danilo Martins ◽  
Sadia Ali ◽  
Shannon Horton ◽  
...  
Keyword(s):  
Organ Procurement ◽  
The United States ◽  
Organ Donors ◽  
Trauma Centers ◽  
Organ Procurement Organization ◽  
Academic Hospitals ◽  
Conversion Rates ◽  
Level I ◽  
Number Of Individuals ◽  
Hospital Characteristics

Consent and conversion rates of potential organ donors in the United States need to be maximized to match the number of individuals awaiting organ donation. Studies to date have not focused on characteristics of centers with better outcomes. We performed an 8-year (2006–2014) retrospective study of our local organ procurement organization database. We categorized hospitals in our region as academic centers versus nonacademic centers, trauma centers versus nontrauma centers, and large (≥400 beds) centers versus small (<400 beds) centers. We also compared trauma centers with Level I designation to all other centers. Primary outcomes included consent and conversion rates for potential organ donors. There were 22,732 referrals to our organ procurement organization that resulted in 1,057 eligible deaths. When comparing academic to nonacademic hospitals, academic hospitals had higher consent (71% vs 59%, P < 0.0001) and conversion (73% vs 64%, P = 0.008) rates. Level I trauma centers had better consent and conversion rates when compared to all other hospitals, 73 versus 55 per cent and 76 versus 61 per cent respectively, P < 0.0001 for both. The small, academic, trauma centers had the highest consent and conversion rates, 77 and 78 per cent, respectively, P < 0.0001 for both. Hospital characteristics such as academic involvement, Level I trauma designation, and size impact consent and conversion rates for potential organ donors. Small (<400 bed), academic, trauma centers have the highest consent rates and conversion rates. Factors for success in these institutions should be examined and applied to assist in improving donor rates across all types of hospitals.

The Role of the Organ Procurement Organization (DSO) in Coordinating Organ Donation in Germany and the Organ Donation Initiative Plan (Sponsor: Novartis Pharma GmbH, Nürnberg)

2020 ◽  
Vol 08 (01) ◽  
pp. 20-23
Keyword(s):  
Organ Donation ◽  
Organ Procurement ◽  
European Countries ◽  
Organ Donors ◽  
Organ Procurement Organization ◽  
Deutsche Stiftung Organtransplantation ◽  
Key Factor

AbstractOrgan donation in Germany started to decline in 2010 and dropped to a 20-year low of 797 organ donors in 2017. The rate of 9.7 organ donors per million population is far below donor rates in other European countries. The Deutsche Stiftung Organtransplantation (DSO, German Organ Procurement Organization) has been concerned about this development for many years and, in cooperation with German donor hospitals, has conducted extensive analyses to identify possible causes. While the causes are multifarious, the DSO sees the improvement of the identification and referral of potential organ donors in hospitals as a key factor in enhancing organ donation rates.

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