Does Location Matter for Withdrawal of Donation After Cardiac Death Donors ?
1Surgery, University of California-San Diego, La Jolla, CA
2Lifesharing, San Diego, CA.
Meeting: 2016 American Transplant Congress
Abstract number: B100
Keywords: Donors, marginal, non-heart-beating
Session Information
Session Name: Poster Session B: Donor Management: All Organs
Session Type: Poster Session
Date: Sunday, June 12, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Purpose: Withdrawal for DCD donors traditionally occurs in the OR. Families often refuse to proceed with DCD donation if they are unable to be present when the donor expires. This series looks at the outcomes of 67 DCD donors where withdrawal occurred outside of the OR in either the PACU or ICU.
Methods: Statistical analysis was completed using t-test and chi-square models. Per OPO protocol, death is confirmed after a 5-min waiting period during which transport occurs to the OR.
Results: A total of 125 organs were transplanted, including 111 kidneys, 11 livers, and 3 lungs. There was a significant difference in time from cardiac time of death (CTOD) to arrival in the OR and warm ischemic time (WIT) when withdrawal occurred in the ICU compared to the PACU. There was no difference between number of organs recovered, transplanted, or outcomes after transplantation between the two groups (Table 1). There was also no difference between the groups when withdrawal outside of the OR was compared to OR withdrawal (Table 2).
Conclusion: Withdrawal for DCD donors can occur outside of the operating room without a difference in outcome. Withdrawal in the PACU may be superior to withdrawal in the ICU due to proximity, especially when procuring non-renal organs. Withdrawal outside of the OR allows families to be with their loved ones which may improve both family and hospital perceptions of organ recovery and increase the number of organs available for transplant.
|
Group |
PACU (30) min |
ICU (32)min |
p-value |
|
Extubation to CTOD |
15 (2 – 30) |
16 (1-53) |
0.6287 |
|
CTOD – OR |
2 (0 – 5) |
3 (0-11) |
0.0002 |
| WIT |
22 (14-33) |
26 (8-54) |
0.0225 |
|
Kidneys transplanted |
49/60 |
52/64 |
1.0000 |
|
DGF |
14/30 |
12/32 |
0.6073 |
|
Kidney Graft Loss |
3/30 |
3/32 |
1.000 |
|
Livers transplanted |
8 /30 |
3/32 |
0.1836 |
|
Liver graft loss |
2/8 |
1/3 |
1.000 |
|
Lungs transplanted |
1 |
0 |
|
|
Group |
PACU/ICU (62) min |
OR (5) min |
p-value |
|
Extubation to CTOD |
16 (11-53) |
21 (9-53) |
0.2273 |
|
CTOD to OR |
2 (0-11) |
0 |
>0.0001 |
|
Warm Ischemic Time |
24 (8 – 54) |
29 (18 – 49) |
0.1512 |
|
Kidneys Transplanted |
101/124 |
10/10 |
0.2100 |
|
DGF |
26/62 |
4/5 |
0.1649 |
|
Kidney Graft Loss |
6/62 |
1/5 |
0.4345 |
|
Livers Transplanted |
11 |
0 |
0.5817 |
|
Liver Graft Loss |
3 |
0 |
|
|
Lungs Transplanted |
1 |
2 |
|
CITATION INFORMATION: Mekeel K, Garrison W, Trageser J, Berumen J, Stocks L, Hemming A. Does Location Matter for Withdrawal of Donation After Cardiac Death Donors ? Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Mekeel K, Garrison W, Trageser J, Berumen J, Stocks L, Hemming A. Does Location Matter for Withdrawal of Donation After Cardiac Death Donors ? [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/does-location-matter-for-withdrawal-of-donation-after-cardiac-death-donors/. Accessed November 22, 2024.« Back to 2016 American Transplant Congress