Date: Tuesday, June 5, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Intro: Variation among procedures across Organ Procurement Organizations (OPOs) may account for discrepancies in outcomes associated with the use of deceased after cardiac death (DCD). Organs. We investigated the degree to which variation across OPOs exists.
Methods: A general survey was sent to the clinical directors of all 58 OPOs and descriptive statistics were calculated.
Results: 55 (94.8%) of OPOs answered some/all of the survey. Among respondents, 40 (72.7%) reported heparin administration prior to withdraw from life support, with 15 (37.5%) giving heparin several minutes (generally 3-5) prior to withdraw and 9 (22.5%) immediately prior. 19 (34.5%) of OPOs used rapid laparotomy to obtain organs, with just 2 allowing for use of cannulation. 8 (14.5%) used neither procedure. 2 OPOs used vasodilators (hydralazine or thorazine) during the DCD process, and 2 more allowed for the possibility.
The preferred locations of withdrawal of life support included the OR for 30 (54.5%), PACU for 6 (11%), or ICU for 5 (9.1%), with most of the rest deferring to hospital policy. Many OPOs allowed for multiple methods of declaration of death, with the most common asystole/PEA (14, 25.5%), auscultation of heart tones (13, 23.6%), or blood pressure monitoring (6, 11%); 23 (42%) deferred to the declaring physician or hospital. 13 (23.6%) OPOs allowed for a waiting period of 2 minutes after declared death, while 38 (69%) waited 5. Waiting times for expiration varied from 60 minutes (33%) to up to 90 (33%), to up to 120 minutes (11%). 5 OPOs reported liver perfusion, and 12 (22%) reported BMI cutoffs, ranging from 35 to 60, with 50 being the most common (7 OPOs).
Conclusion: Significant variation exists across OPO protocols, including administration of heparin, waiting times for declaration and organ recovery, withdrawal location, and BMI cutoffs. Further exploration is needed to determine the impact of these differences on organ outcomes.
CITATION INFORMATION: Mitro G., Ortiz A., Warnock R., Wiederhold P., Jiles K., Ortiz J. Consistency of DCD Procurement Procedures across Organ Procurement Organizations – Preliminary Findings Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Mitro G, Ortiz A, Warnock R, Wiederhold P, Jiles K, Ortiz J. Consistency of DCD Procurement Procedures across Organ Procurement Organizations – Preliminary Findings [abstract]. https://atcmeetingabstracts.com/abstract/consistency-of-dcd-procurement-procedures-across-organ-procurement-organizations-preliminary-findings/. Accessed September 22, 2019.
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