Objective:

Certain donor management parameters (DMP) have been established at some organ procurement organizations (OPO) to guide management decisions to optimize donor organ transplantation. This study evaluates the relationship between DMPs achieved and organs transplanted per donor (OTPD) at a single OPO.

Methods:

This is a retrospective analysis of donor records from 2008 to 2012. Demographic information (age, weight, cause of death, length of ICU stay) and DMPs were recorded. Seven DMP criteria were recorded: serum sodium < 155 mEq, mean arterial pressure > 60 mmHg, < 2 vasopressors, serum pH 7.35-7.45, central venous pressure < 10 mmHg, PaO2/FiO2 > 300, and urine output 1-2 cc/kg/hr. These parameters were recorded at four time points: admission, consent for donation, 12 hours post-consent, and time of procurement. Total number of solid organs transplanted per donor was recorded.

Results:

There were 499 donors analyzed. DMP met at four time points were as follows (mean): 3.3 admission, 3.3 consent, 3.7 12 hours post-consent, and 3.6 procurement. For the purpose of the study, three groups were defined at each time point: donors meeting 0-3, 4, and 5-7 DMPs. The figures show organs transplanted by number of DMPs at each time point (figure 1), and successful transplant of each solid organ (figure 2).

Conclusions:

There is improved organ yield per donor when meeting a higher number of established DMP at each of four time points. These results suggest that the ability to adhere to strict management parameters may increase the yield of transplantable organs per donor. It remains unclear from these data whether adherence to DMPs improves graft and patient outcomes post transplant.

Acknowledgement: Data for this analysis were collected and provided by the Indiana Organ Procurement Organization.

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