2013 - ISODP 2013 Congress


Oral Presentation 5 on DCD Programs 2

12.1 - Over 1,400 DCD Organs Transplanted in 18 Years: An Effective Organ Procurement Organization's DCD Program Increases the Donor Pool

Presenter: Howard, Nathan, Philadelphia, United States
Authors: Howard M. Nathan, Richard D. Hasz, John D. Abrams, Sharon M. West, Michael J. Moritz, MD


Over 1,400 DCD Organs Transplanted in 18 Years: An Effective Organ Procurement Organization's DCD Program Increases the Donor Pool

Howard M. Nathan1, Richard D. Hasz1, John D. Abrams1, Sharon M. West1, Michael J. Moritz, MD1

1Gift of Life Donor Program, Philadelphia, PA, United States

Aim: Demonstrate an effective DCD program increases organ donor pool & provides lifesaving transplants to those on the waiting list.

Methods:  A single OPO, multi-center study evaluating the recovery & utilization of DCD donor organs. Ongoing hospital education on early referral & DCD protocols were initiated prior to DCD donor recoveries. Transplant outcomes were evaluated using the Kaplan-Meier method.

Results: Since implementation of its DCD program (Jun 1995 - Dec 2012), OPO has procured 806 DCD organ donors. DCDs increased the donor pool by 13% resulting in the transplant of 1,468 organs. Mean donor age was 39 yrs (r = 0.5-76). Mean time from donor extubation to cross-clamp, or warm ischemic time (WIT), for kidneys transplanted (n=1,272) was 32 minutes (r = 2-214). Mean WIT for livers transplanted (n=175) was 19 minutes (r = 2-69). Of the 806 DCD organ donors, 658 (82%) were Maastricht Category 3; 74 were Category 2; & 74 were Category 4. Kidney ATN rate was 46% & kidney graft survival was 86% at 1 yr, 75% at 3 yrs & 64% at 5 yrs. Liver graft survival was 72% at 1 yr, 63% at 3 yrs & 56% at 5 yrs.

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Conclusion: An effective DCD program and clinical practice can lead to an increase in the availability of transplantable organs.  Properly implemented OPO donor referral protocols can result in an increase in procurement of DCD organ donors.  Further research should be considered to identify ways to increase DCD liver, lung and pancrease utilization.

Figure 1


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