A Novel Organ Donor Facility: A Decade of Experience With Liver Donors

Abstract

Transplant surgeons have historically traveled to donor hospitals, performing complex, time-sensitive procedures with unfamiliar personnel. This often involves air travel, significant delays, and frequently occurs overnight. In 2001, we established the nation's first organ recovery center. The goal was to increase efficiency, reduce costs and reduce surgeon travel. Liver donors and recipients, donor costs, surgeon hours and travel time, from April 1, 2001 through December 31, 2011 were analyzed. Nine hundred and fifteen liver transplants performed at our center were analyzed based on procurement location (living donors and donation after cardiac death donors were excluded). In year 1, 36% (9/ 25) of donor procurements occurred at the organ procurement organization (OPO) facility, rising to 93% (56/60) in the last year of analysis. Travel time was reduced from 8 to 2.7 h (p < 0.0001), with a reduction of surgeon fly outs by 93% (14/15) in 2011. Liver organ donor charges generated by the donor were reduced by 37% overall for donors recovered at the OPO facility versus acute care hospital. Organs recovered in this novel facility resulted in significantly reduced surgeon hours, air travel and cost. This practice has major implications for cost containment and OPO national policy and could become the standard of care.

Donor Age-Based Analysis of Liver Transplantation Outcomes: Short- and Long-Term Outcomes Are Similar Regardless of Donor Age

“…We speculated that this shortened CIT was responsible for our improved results, especially in the older donor grafts, and have continued that practice since our initial report. The development of our offsite organ recovery facility 19 has greatly facilitated our ability to maintain short CITs.…”

“…19 Procurement liver biopsy is performed selectively based on gross appearance of the liver and medical history of the donor.…”

Organ procurement center allows for daytime liver transplantation with less resource utilization: May address burnout, pipeline, and safety for field of transplantation

“…2,9 There are currently 9 other OPCs in the United States, and the one in our Organ Procurement Organization (OPO) is the longest functioning center. 2,9 There are currently 9 other OPCs in the United States, and the one in our Organ Procurement Organization (OPO) is the longest functioning center.…”

Early Clinical Results Using Normothermic Machine Liver Preservation

“…Recently, some transplant regions have started to transfer donors to a transplant center instead of transporting the organ alone. Thus, transportation of a DCD donor under ECMO recirculation could be possible [43]. The combination of both organ procurement under in situ perfusion and normothermic ex vivo preservation after procurement demonstrated an even more favorable effect on preservation/reperfusion injury and functional transplantation outcomes in grafts exposed to 90 min of warm ischemia [44].…”