The First 2 Years of Activity of a Specialized Organ Procurement Center: Report of an Innovative Approach to Improve Organ Donation

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Abstract

Introduction

The number of patients requiring organ transplants continue to outgrow the number of organs donated each year. In an attempt to improve the organ donation process and increase the number of organs available, we created a specialized multidisciplinary team within a specialized organ procurement center (OPC) with dedicated intensive care unit (ICU) beds and operating rooms.

Method

The OPC was created within the ICU structure of a university-affiliated tertiary care center. The OPC receives adult patients from 20 local and regional health care centers. The OPC offers access to all advanced diagnostic procedures and equipment required for organ donor management (ODM) and organ retrieval. This new organizational approach centralizes all services necessary for ODM and organ retrieval, as illustrated in Figure 1. The OPC was staffed with dedicated 24h a day, 7 days a week (24/7), on call ICU nurses, operating room (OR) nurses and ODM ICU physicians. Two ICU beds and one OR are dedicated at all times to the OPC. A critical care physician is available at all times to offer telephone consultations to any referring center. The OPC receives the donor within 1 h maximum of a transfer request. A dedicated critical care physician directly manages the potential organ donors during the entire period of organ recruitment and allocation. A pathologist is on call 24/7 for consultations during both ODM and retrieval procedures. All organ donors within a designated geographic area were transferred to and managed within the OPC.

Results

During the first 2 years of operation, 126 patients were referred to the OPC. The OPC was in use for a total of 3527 h and involved 253 health workers. We retrieved 173 kidneys, 95 lungs, 68 livers, 37 hearts, and 13 pancreases for a total of 386 organs offered for transplantation. Comparing the 2-year period before and after the CPO implementation, the number of persons transplanted with cadaveric organs PMP increased from 93.1 to 124.6, which compares most favourably to recently published numbers in developed countries.

Conclusion

The organizational structure of the OPC clearly demonstrates potential to increase the number of deceased donor organs available for transplant. Further studies are warranted to better understand the exact influence of the different components of the OPC on organ procurement.

References

1. Marsolais P. et al. The First 2 Years of Activity of a Specialized Organ Procurement Center: Report of an Innovative Approach to Improve Organ Donation. Am J Transplant. 2016 Nov 22.

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