Intra-abdominal Hypertension And Abdominal Compartment Syndrome: An Organ Procurement Organization’S Experience
1Midwest Transplant Network, Westwood, KS, 2Via Christi St Francis, Wichita, KS, 3University of Kansas Medical Center, Kansas City, KS, 4Lake Regional Health System, Osage Beach, MO, 5Wesley Medical Center, Wichita, KS, 6University of Missouri Health Care, Columbia, MO, 7University of Missouri - Kansas City, Kansas City, MO
Meeting: 2019 American Transplant Congress
Abstract number: 383
Keywords: Donation, Procurement
Session Information
Session Name: Concurrent Session: Donor Management: All Organs Excluding Kidney
Session Type: Concurrent Session
Date: Monday, June 3, 2019
Session Time: 4:30pm-6:00pm
Presentation Time: 5:18pm-5:30pm
Location: Room 313
*Purpose: Because of a shortage of available organs, an average of 22 people die each day waiting for a transplant. There has been significant research of incidence and risk factors for intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) among patients in critical care settings. Studies have shown the incidence of IAH to be between 30 and 60% (Hunt et al, 2017) and ACS to be between 0.5 and 36% (Shaheen et al, 2016). However, there has not been significant research on the risk factors and incidence in the brain dead organ donor population. Complications secondary to IAH and ACS can limit the organs available for transplantation through end-organ dysfunction and gross hemodynamic instability in the donor. Aim: Understanding the risk factors and incidence of IAH and ACS in the brain dead organ donor population will help to promote early identification of these processes and subsequent intervention which may maximize the number of organs suitable for transplantation.
*Methods: Retrospective review of the data from January 2012 through April 2018 was completed to understand the incidence and impact of IAH and ACS in Midwest Transplant Network’s (MTN) brain dead donor population. An MTN created risk factor checklist was utilized to decide which patients to monitor intra-abdominal pressure (IAP).
*Results: There were 1,410 recovered organ donors during this time period. 212 (15%) screened positive and underwent IAP monitoring with 13 (0.9%) indicating invasive intervention – decompressive laparotomy or abdominal drain placement. 11 donors had successful intervention, 2 did not – due to lack of availability of surgeon and family restriction. In the IAP monitoring group (no invasive intervention), overall observed vs expected organs transplanted was 1.07. In the invasive intervention group, overall observed vs expected organs transplanted was 0.99. In the group where intervention was indicated but unable to be completed, the overall observed vs expected organs transplanted was 0.71.
*Conclusions: Intra-abdominal pressure is not an uncommon occurrence in the organ donor population. Timely and accurate identification and intervention may result in more organs transplanted.
To cite this abstract in AMA style:
Stefek J, Markham LE, Ott M, Johnson SS, Olson JC, Sangha H, Vasquez DG, Whitt SP, Wilkins HE, Webster PA, Iliakova M, Moncure M. Intra-abdominal Hypertension And Abdominal Compartment Syndrome: An Organ Procurement Organization’S Experience [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/intra-abdominal-hypertension-and-abdominal-compartment-syndrome-an-organ-procurement-organizations-experience/. Accessed May 9, 2025.« Back to 2019 American Transplant Congress