Back ground: Last year, we presented our improved quality care data of modular training program (step wise surgical training) for all abdominal organ procurements at London Health Sciences Centre (LHSC). In the present era of high BMI donors, it acquires more relevance for optimum safe organ yield.

Material and Methods: Our standard retrieval technique involves more warm dissection, including complete liver and IVC mobilization. This was divided into 5 operative training modules: 1-Major vessels dissection, 2-Liver mobilization, 3-Hepatoduodenal ligament dissection, 4- Cannulation/flushing , 5-Cold dissection. At each procurement, the 1^st year fellow performed only the operative steps that corresponded to his acquired skill level. The mentor (2nd year fellow) performed the remaining part.

The operative records of all abdominal organ procurements performed by LHSC procurement team on donors with BMI more than 30 were reviewed. Any damage to abdominal organ during procurement sustained was reported as a complication. Procurement injury leading to organ not being used was categorized as major complication, procurement injury leading to vascular/organ reconstruction was categorized as moderate complication and procurement injury recognized with no change in surgical management was categorized as mild complication.

Results: Over last 3 years, 44 abdominal organ procurements (16 DCD and 28 DBD) done on donors with BMI >30. (Range 30-56). 102 organs were procured during the said period. 02/102 organs had major complications (kidneys x 2); 05/102 organs had moderate complication (kidneys x 3, liver x 2), 02/102 organs had mild complication. 5/9 complications happened during the first quarter of fellowship training. No injury organ yield was 92 % and successful organ transplant surgery yield was 98%. Organ loss rate was 2%. No injuries were reported from fellowship trainees procuring organs in last 6 months of training.

Conclusions: Modular Training for Organ procurement provides excellent organ yield and organ safety in high BMI donors too, as validated by our results. It continues to be a part of LHSC organ procurement training model.

CITATION INFORMATION: Sharma H, Abraham M.-T, Al Hasan I, Al-Harbi B, Aquil S, Sener A, Luke P, Quan D. Modular Training in Organ Procurement, in the Present Era of High BMI Donors: Validation by Results. Am J Transplant. 2017;17 (suppl 3).

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