Donor management parameters and organ yield: Single center results

George Ryne Marshall, Richard Mangus, John A. Powelson, Jonathan A. Fridell, Chandrashekhar A. Kubal, A. Joseph Tector

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background Management of organ donors in the intensive care unit is an emerging subject in critical care and transplantation. This study evaluates organ yield outcomes for a large number of patients managed by the Indiana Organ Procurement Organization. Materials and methods This is a retrospective review of intensive care unit records from 2008-2012. Donor demographic information and seven donor management parameters (DMP) were recorded at admission, consent, 12 h after consent, and before procurement. Three study groups were created: donors meeting 0-3, 4, or 5-7 DMP. Active donor Organ Procurement Organization management began at consent; so, data analysis focuses on the 12-h postconsent time point. Outcomes included organs transplanted per donor (OTPD) and transplantation of individual solid organs. Results Complete records for 499 patients were reviewed. Organ yield was 1415 organs of 3992 possible (35%). At 12 h, donors meeting more DMP had more OTPD: 2.2 (0-3) versus 3.0 (4) versus 3.5 (5-7) (P < 0.01). Aggregate DMP met was significantly associated with transplantation of every organ except intestine. Oxygen tension, vasopressor use, and central venous pressure were the most frequent independent predictors of organ usage. There were significantly more organs transplanted for donors meeting all three of these parameters (4.5 versus 2.7, P < 0.01). Conclusions Initial DMP met does not appear to be a significant prognostic factor for OTPD. Aggregate DMP is associated with transplantation rates for most organs, with analysis of individual parameters suggesting that appropriate management of oxygenation, volume status, and vasopressor use could lead to more organs procured per donor.

Original languageEnglish
Pages (from-to)208-213
Number of pages6
JournalJournal of Surgical Research
Volume191
Issue number1
DOIs
StatePublished - 2014

Fingerprint

Tissue Donors
Tissue and Organ Procurement
Transplantation
Intensive Care Units
Organizations
Central Venous Pressure
Organ Transplantation
Critical Care
Intestines
Demography
Oxygen

Keywords

  • Critical care
  • Donor management parameters
  • Intensive care unit
  • Organ donor
  • Transplantation

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

Marshall, G. R., Mangus, R., Powelson, J. A., Fridell, J. A., Kubal, C. A., & Tector, A. J. (2014). Donor management parameters and organ yield: Single center results. Journal of Surgical Research, 191(1), 208-213. https://doi.org/10.1016/j.jss.2014.02.054

Donor management parameters and organ yield : Single center results. / Marshall, George Ryne; Mangus, Richard; Powelson, John A.; Fridell, Jonathan A.; Kubal, Chandrashekhar A.; Tector, A. Joseph.

In: Journal of Surgical Research, Vol. 191, No. 1, 2014, p. 208-213.

Research output: Contribution to journalArticle

Marshall, GR, Mangus, R, Powelson, JA, Fridell, JA, Kubal, CA & Tector, AJ 2014, 'Donor management parameters and organ yield: Single center results', Journal of Surgical Research, vol. 191, no. 1, pp. 208-213. https://doi.org/10.1016/j.jss.2014.02.054
Marshall, George Ryne ; Mangus, Richard ; Powelson, John A. ; Fridell, Jonathan A. ; Kubal, Chandrashekhar A. ; Tector, A. Joseph. / Donor management parameters and organ yield : Single center results. In: Journal of Surgical Research. 2014 ; Vol. 191, No. 1. pp. 208-213.
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N2 - Background Management of organ donors in the intensive care unit is an emerging subject in critical care and transplantation. This study evaluates organ yield outcomes for a large number of patients managed by the Indiana Organ Procurement Organization. Materials and methods This is a retrospective review of intensive care unit records from 2008-2012. Donor demographic information and seven donor management parameters (DMP) were recorded at admission, consent, 12 h after consent, and before procurement. Three study groups were created: donors meeting 0-3, 4, or 5-7 DMP. Active donor Organ Procurement Organization management began at consent; so, data analysis focuses on the 12-h postconsent time point. Outcomes included organs transplanted per donor (OTPD) and transplantation of individual solid organs. Results Complete records for 499 patients were reviewed. Organ yield was 1415 organs of 3992 possible (35%). At 12 h, donors meeting more DMP had more OTPD: 2.2 (0-3) versus 3.0 (4) versus 3.5 (5-7) (P < 0.01). Aggregate DMP met was significantly associated with transplantation of every organ except intestine. Oxygen tension, vasopressor use, and central venous pressure were the most frequent independent predictors of organ usage. There were significantly more organs transplanted for donors meeting all three of these parameters (4.5 versus 2.7, P < 0.01). Conclusions Initial DMP met does not appear to be a significant prognostic factor for OTPD. Aggregate DMP is associated with transplantation rates for most organs, with analysis of individual parameters suggesting that appropriate management of oxygenation, volume status, and vasopressor use could lead to more organs procured per donor.

AB - Background Management of organ donors in the intensive care unit is an emerging subject in critical care and transplantation. This study evaluates organ yield outcomes for a large number of patients managed by the Indiana Organ Procurement Organization. Materials and methods This is a retrospective review of intensive care unit records from 2008-2012. Donor demographic information and seven donor management parameters (DMP) were recorded at admission, consent, 12 h after consent, and before procurement. Three study groups were created: donors meeting 0-3, 4, or 5-7 DMP. Active donor Organ Procurement Organization management began at consent; so, data analysis focuses on the 12-h postconsent time point. Outcomes included organs transplanted per donor (OTPD) and transplantation of individual solid organs. Results Complete records for 499 patients were reviewed. Organ yield was 1415 organs of 3992 possible (35%). At 12 h, donors meeting more DMP had more OTPD: 2.2 (0-3) versus 3.0 (4) versus 3.5 (5-7) (P < 0.01). Aggregate DMP met was significantly associated with transplantation of every organ except intestine. Oxygen tension, vasopressor use, and central venous pressure were the most frequent independent predictors of organ usage. There were significantly more organs transplanted for donors meeting all three of these parameters (4.5 versus 2.7, P < 0.01). Conclusions Initial DMP met does not appear to be a significant prognostic factor for OTPD. Aggregate DMP is associated with transplantation rates for most organs, with analysis of individual parameters suggesting that appropriate management of oxygenation, volume status, and vasopressor use could lead to more organs procured per donor.

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