Management of Brain-Dead Organ Donors by a Dedicated ICU Team Improves Organ Yield

G. L. Piper¹, B. E. Sullivan¹, G. Boulton¹, T. C. Lewis¹, J. Pavone¹, C. Ezzell², D. E. Smith III³, L. Angel¹, N. Moazami³, R. Montgomery¹

¹NYU Langone Transplant Institute, New York, NY, ²LiveOnNY, New York, NY, ³Cardiothoracic Surgery, NYU Langone Health, New York, NY

Meeting: 2022 American Transplant Congress

Abstract number: 1778

Keywords: Brain death, Donation, Organ Selection/Allocation, Procurement

Topic: Clinical Science » Organ Inclusive » 68 - Deceased Donor Management and Intervention Research

Session Information

Session Name: Deceased Donor Management and Intervention Research

Session Type: Poster Abstract

Date: Tuesday, June 7, 2022

Session Time: 7:00pm-8:00pm

Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: Management of brain-dead (BD) donors can be challenging in hospitals with limited ICU bed availability, lack of accessible diagnostic capabilities, and a culture that does not prioritize non-living patient care. Care and optimization of BD donors in a centralized donor management center (CDMC) by a dedicated ICU team may improve organ yield.

*Methods: A CDMC was created at NYU Langone Health in Manhattan that encouraged transfer of BD donors within the Donation Service Area. The surgical ICU team admitted and managed the patient with the use of BD donor-specific lung recruitment and fluid management protocols as well as existing ICU workflows. Bronchoscopy, renal replacement therapy, and central access and invasive monitoring were performed if indicated. Consults were obtained as needed and donor diagnostics were completed with the same priority as other ICU patients. Once optimized, allocation occurred, and the procurement was scheduled in a designated donor operating room. Independent samples T test was used to compare mean organs transplanted per donor (TPD) between our institution and the organ procurement organization (OPO).

*Results: From March 1, 2021 to October 31, 2021, 54 potential BD organ donors were transferred to the CDMC at NYU Langone Health. 154 total organs were procured and transplanted from 44 organ donors including 19 hearts, 27 lungs, 40 livers, and 64 kidneys. Ten BD patients were consented but had no organs recovered for transplant. Mean organs TPD in this setting was 3.5. Hearts, lungs, livers, and kidneys TPD were 0.43, 0.61, 0.91, and 1.45, respectively. Utilizing SRTR data for 2020, total organs TPD were higher at the CDMC compared to the OPO (mean diff. -0.72, 95% CI -0.98 – (-0.47), p<0.01) Individual organs TPD were all higher at the CDMC compared to the OPO. Lungs and livers TPD were significantly higher at the CDMC.

*Conclusions: A dedicated ICU team at a centralized donor management center to optimize BD donors for allocation and procurement significantly increased the number of total organs TPD, as well as lungs and livers TPD.

To cite this abstract in AMA style:

Piper GL, Sullivan BE, Boulton G, Lewis TC, Pavone J, Ezzell C, III DESmith, Angel L, Moazami N, Montgomery R. Management of Brain-Dead Organ Donors by a Dedicated ICU Team Improves Organ Yield [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/management-of-brain-dead-organ-donors-by-a-dedicated-icu-team-improves-organ-yield/. Accessed December 3, 2024.

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