Development of a competence based training programme for perioperative practitioners undertaking in-situ normothermic regional preservation in DCD donors

John Stirling¹, Gabriel Oniscu¹, Ian Currie¹, Pamela Stenhouse¹, Graham Johnston¹

¹Scottish Organ Retrieval Team, NHS Lothian, Edinburgh, United Kingdom

Normothermic Regional Perfusion (NRP) is a new approach to DCD organ retrieval involving normothermic oxygenated blood perfusion rather than cold perfusion. This may improve organ viability and quality and potentially increase the number of organs recovered.

In Scotland, there is a unified multi-organ retrieval team, the Scottish Organ Retrieval Team (SORT). This includes perioperative practitioners responsible for multi-organ perfusion and preservation. Traditionally, this involves hypothermic preservation and packing the organs for cold storage. NRP requires greater specialist knowledge of physiology, biochemistry and organ assessment. In conjunction with the lead clinician for the NRP project, it was identified that the senior perioperative practitioners from SORT would undertake an education and training programme followed by competence assessment. This was developed in collaboration with the practice development team using a Standard Operating Procedure (SOP). This training programme was divided into four distinct phases: theoretical learning, practical observation, experiential learning and competence assessment. The theoretical learning component included education sessions (anatomy, physiology, biochemistry and the components of the console, circuit and pump). Practical observation included visiting centres using NRP in clinical practice and attending practical workshops. The experiential learning component involved animal labs sessions and repetition of the practical steps laid out in the SOP. The final competence assessment was undertaken once the education and training components had been completed. The lead clinician for the NRP project carried out the competence assessments. Four practitioners have successfully undergone competence assessment and are involved with NRP in clinical practice.

This approach could serve as a model for future development in organ retrieval and preservation and the expansion of the role of transplant theatre practitioners.