Wave of the Future: Expanding Role and Necessity of the Dedicated Procurement Surgeon
New England Donor Services, Waltham, MA
Meeting: 2021 American Transplant Congress
Abstract number: LB 25
Keywords: Donation, Employment, Procurement, Surgical complications
Topic: Administrative » Quality Assurance Process Improvement & Regulatory Issues
Session Information
Session Name: Quality Assurance Process Improvement & Regulatory Issues
Session Type: Poster Abstract
Session Date & Time: None. Available on demand.
Location: Virtual
*Purpose: To evaluate the quantitative and qualitative benefits of a dedicated procurement surgeon (DPS) across the transplant spectrum, including the DPS technical performance value for transplant recipients and the organ procurement organization (OPO). Non-technical benefits of the DPS in optimizing organ utilization include the opportunity to pursue more marginal and kidney-only donors, employment of longer wait times for donation after cardiac death donors, delay of cross clamp during intraoperative liver turn downs, and technical expertise with kidney perfusion pumps.
*Methods: We performed a retrospective analysis of technical performance in the recovery of deceased donor abdominal organs within our donor service area (DSA) after the first complete year of an OPO-employed DPS. The DPS performance was compared to surgical recovery data by non DPS surgeons in the same time period, and also in the two prior years of DSA experience without DPS recovery. Organ damage was classified as tier 1, representing minor technical error, and tier 2, representing surgical damage that rendered organs non-transplantable.
*Results: Between January 6, 2020 to January 6, 2021, a total of 946 abdominal organs were procured for transplantation within the DSA. The incidence of DPS surgical damage was 2 of 290 organs (0.69%), and both were tier 1 injuries; there were 0 tier 2 injuries (no organ loss). Incidence of non DPS surgical damage in the same period was 9 of 656 organs (1.4%). Of those 656 organs, there were 6 tier 1 injuries (0.91%) and 3 tier 2 injuries (0.46%) resulting in organ loss. Over the prior two years, 2,145 abdominal organs were procured―all non DPS―with surgical damage noted in 45 organs (2.1%). Tier 1 injuries occurred in 33 of 2,145 organs (1.5%) and tier 2 injuries in 12 of 2,145 organs (0.56%).
*Conclusions: The technical expertise of DPS recovery is evident and of significance to the optimization of organ utilization and transplant recipient outcome. Surgical damage of procured organs is not common, but has substantial effects on OPO’s, transplant centers, and organ recipients. Maximizing successful organ recovery and utilization is achieved through the creation of the OPO-employed DPS, as we demonstrate substantive differences in technical performance and outcomes of the DPS compared to non DPS surgeons.
| 2018 and 2019 (all non DPS) | 2020 (non DPS) | 2020 (DPS) | |
| Abdominal organs procured | 2,145 | 656 | 290 |
| Organs damaged (% of total) | 45 (2.1%) | 9 (1.4%) | 2 (0.69%) |
| Tier 1 injuries (% of total) | 33 (1.5%) | 6 (0.91%) | 2 (0.69%) |
| Tier 2 injuries (% of total) | 12 (0.56%) | 3 (0.46%) | 0 |
To cite this abstract in AMA style:
Strom C, Cimsit B, Nelson H, Delmonico F. Wave of the Future: Expanding Role and Necessity of the Dedicated Procurement Surgeon [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/wave-of-the-future-expanding-role-and-necessity-of-the-dedicated-procurement-surgeon/. Accessed November 24, 2024.« Back to 2021 American Transplant Congress