Attaining specific donor management goals increases number of organs transplanted per donor: a quality improvement project

Abstract

Most organ procurement organization professionals and transplant surgeons intuitively know that meeting donor management goals improves organ allocation and transplant outcomes. In this era of evidence-based medicine, it is important to know whether the data support this assumption. All 6 organ procurement organizations in the United Network for Organ Sharing's region 10 agreed on 6 specific donor management goals. The organ procurement organizations then compared the number of organs transplanted per donor when goals were met with the number when goals were not met. Results were broken down by donor type: standard-criteria donation, expanded-criteria donation, and donation after cardiac death. For all 6 organ procurement organizations combined, the data for all of 2008 show a substantial and statistically significant improvement in number of organs transplanted per donor for standard criteria donation and total donors when goals are met, with a smaller degree of improvement (although not statistically significant) in the number of organs transplanted per donor for expanded-criteria donation and donation after cardiac death when goals are met.

The Impact of Meeting Donor Management Goals on the Development of Delayed Graft Function in Kidney Transplant Recipients

“…The DTCP encourages the utilization of preset critical care endpoints as donor management goals (DMG) in order to increase both the number of organs transplanted per donor (OTPD) as well as overall conversion rates. Meeting predefined DMGs has demonstrated beneficial effects on OTPD (2)(3)(4)(5). However, there are often reasons for organ acceptance/declination that are unrelated to donor management or graft quality, making it difficult to truly identify best practices by merely focusing on organ utilization/transplantation rates.…”

Addition of Direct Peritoneal Lavage to Human Cadaver Organ Donor Resuscitation Improves Organ Procurement

“…Data published from 3 different United Network for Organ Sharing regions has demonstrated a relationship between DMGs and OTPD. [10][11][12][13] Donor management goals can offer insight into goals for resuscitation end points, however, few data have been published on methods to alter physiology during resuscitation or optimal parameters of resuscitation.…”

Brain Death: Assessment, Controversy, and Confounding Factors

“…Nurses are integral in quickly recognizing progressive injury and terminal brain stem herniation, providing aggressive care, and decreasing the number of silent brain deaths. 10 These actions can improve donor recognition, optimize resource utilization in the intensive care unit (ICU), increase availability of potentially transplantable organs, 11 and enable early initiation of goal-directed therapy, 12 improving physiological stability and organ function.…”