Care pathways for organ donation after brain death: guidance from available literature?

Hoste, Pieter; Vanhaecht, Kris; Ferdinande, Patrick; Rogiers, Xavier; Eeckloo, Kristof; Blot, Stijn; Hoste, Eric A. J.; Vogelaers, Dirk; Vandewoude, Koenraad

doi:10.1111/jan.13051

Cited by 8 publications

(8 citation statements)

References 53 publications

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“…Maintaining the current policy framework for organ donation does not require complacency regarding the ongoing challenge of the organ shortfall. Nurses should advocate for alternative strategies to expand the number of likely usable organs using increased use of care pathways for donation after brain death (Hoste et al., 2016). In addition, scientific developments in the preservation and storage may be employed to increase the number of organs transplanted from the available pool (Mundt, Yard, Krämer, Benck, & Schnülle, 2015; Watson & Bradley, 2011).…”

Section: Discussionmentioning

confidence: 99%

Organ Donation After Circulatory Death and Before Death: Ethical Questions and Nursing Implications

Tantillo

González

Ortega

2019

Policy, Politics, & Nursing Practice

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Scientific advances have enabled thousands of individuals to extend their lives through organ donation. Yet, shortfalls of available organs persist, and individuals in the United States die daily before they receive what might have been lifesaving organs. For years, the legal foundation of organ donation in the United States has been known as the Dead Donor Rule, requiring death to be defined for organ donation purposes by either a cardiac standard (termination of the heartbeat) or a neurological one (cessation of all brain function). In this context, one solution used by an increasing number of health care facilities since 2006 is donation after circulatory death, generally defined as when care is withdrawn from individuals who have known residual brain function. Despite its increased use, donation after circulatory death remains ethically controversial. In addition, some ethicists have advocated forgoing the Dead Donor Rule altogether and allowing donation before or near death in certain circumstances. However, nurses and other health professionals must carefully consider the practical and ethical implications of broadening the Dead Donor Rule—as may be already occurring—or removing it entirely. Such changes could harm both the integrity of the health care system as well as efforts to secure organ donation commitments from the public and are outweighed by the moral and pragmatic cost. Nurses should be prepared to confront the challenge posed by the ongoing scarcity of organs and advocate for ethical alternatives including research on effective care pathways and education regarding organ donation.

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Section: Discussionmentioning

confidence: 99%

Organ Donation After Circulatory Death and Before Death: Ethical Questions and Nursing Implications

Tantillo

González

Ortega

2019

Policy, Politics, & Nursing Practice

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“…Fuzzati (2005) divides the transplant process into organ retrieval and implant surgery. Finally, Hoste et al (2016) studied the literature about the process, such as care pathways for organ donation after brain death (BD). Engineering and Operations Management Lisbon, Portugal, July 18-20, 2023 © IEOM Society International According to Mota et al (2020), the ODTP adds value in a major supply chain context.…”

Section: The Organ Donation and Transplantation (Odt) Supply Chain An...mentioning

confidence: 99%

“…However, several authors argued that the number of transplants would significantly increase if we eliminated the inefficiencies in the organ donation supply chain and process. In this regard, different authors worldwide and in Brazil report that the loss of organs occurs throughout the entire process, from identifying donors to problems during the transplant surgery (Matesanz and Domínguez-Gil 2007;Shanmugarajah et al 2014;Rosendale et al 2011;Hoste et al 2016;Matesanz et al 2017;Hobeika et al 2017;Duran 2017;Arora and Subramanian 2019;Paim and Figueiredo 2019;Mota et al 2020;Soares et al 2020;Lewis et al 2020;Cole 2021;Silva et al 2021;Marinho and Araujo 2021;ABTO 2023). In this context, the organ donation and transplantation supply chain and its processes (ODTP) can be improved if applying the Industrial or Production Engineering and Operations Management body of knowledge (Howard 2007;Arora and Subramanian 2019).…”

Section: Introductionmentioning

confidence: 99%

Analysis of the Organ Donation and Transplant Process with Process Mining: Comparing 2021 and 2022 Supply Chain Data in Rio de Janeiro

Paim,

Senna,

Moura

et al. 2023

Proceedings of the International Conference on Industrial Engineering and Operations Management

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The organ donation and transplantation supply chain -ODTSC is a complex and multi-professional system with donors, organs, recipients, and waiting families on the upstream chain side and transplanted patients, and their families, on the supply chain downstream side. Health professionals must coordinate and streamline the donation, transplantation, and transplanted patients' care, as the 3 main processes in the ODTSC. These processes have been improving in several countries, but the global demand for donated organs is nearly 1,3 to 2 million and the transplantation capacity is below 150,000 surgeries. The research was motivated by low performance when comparing Rio de Janeiro data from 2021 and 2022 to benchmarks and its main objective was to improve practices by analyzing the ODTSC and its process and data. Process mining -PM has been evolving from a process and data science topic to a useful technology related to production engineering. In health services, the hospital environment, health production systems, and society benefit from PM utilization with a new way to increase value. Discover the variants, checking the conformance to regulations, analyzing causes, and proposing improvements are PM techniques used to enhance performance and reduce the gap between organ demand and supply. The data was used to analyze the process design, the data itself, and indicators by applying PM techniques and using a tool. The methodology was based on the design research and multiple studies cases methods with a bibliographical review -and no previous work was found, demonstrating the novelty of this research; PM tools selection, data preparation; and interviews to identify improvements. With the study, it was possible to demonstrate the applicability of PM, and an increase of 15 % in organs donated in Rio de Janeiro ODTSC was observed.

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“…4,5 Therefore, evidence-based recommendations are an important tool to guide best practices for the care of deceased donors in intensive care units (ICUs). 6 Nevertheless, rigorous highgrade evidence in the organ donor care field is lacking and guidelines derived from expert consensus opinions may represent the highest evidence to guide clinicians' practices.…”

Section: Résumémentioning

confidence: 99%

Worldwide management of donors after neurological death: a systematic review and narrative synthesis of guidelines

Frenette

Weiss

Rochwerg

et al. 2020

Can J Anesth/J Can Anesth

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Objective The objectives of this study were to systematically identify and describe guidelines for the care of neurologically deceased donors and to evaluate their methodological quality, with the aim of informing and supporting the new Canadian guidelines for the management of organ donors. Methodology Following a systematic search, we included any document endorsed by an organ donation organization, a professional society, or a government, that aims to direct the medical management of adult, neurologically deceased, multi-organ donors. We extracted recommendations pertaining to six domains: the autonomic storm, hemodynamic instability, hormone supplementation, ventilation, blood product transfusions, and general intensive care unit (ICU) care. Methodological quality of the guidelines was assessed by the validated AGREE-II tool.

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Care pathways for organ donation after brain death: guidance from available literature?

Abstract: Further research should focus on the development and standardization of the clinical content of a care pathway for donation after brain death and the identification of quality indicators. These should be used in a prospective effectiveness assessment of the proposed pathway.

Cited by 8 publications

References 53 publications

Organ Donation After Circulatory Death and Before Death: Ethical Questions and Nursing Implications

Organ Donation After Circulatory Death and Before Death: Ethical Questions and Nursing Implications

Analysis of the Organ Donation and Transplant Process with Process Mining: Comparing 2021 and 2022 Supply Chain Data in Rio de Janeiro

Worldwide management of donors after neurological death: a systematic review and narrative synthesis of guidelines

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