2013 - ISODP 2013 Congress


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Oral Presentation 11 on Intensive Care and Donation

23.7 - A 17 Year Summary of One OPO's Changing Pool of Potential Donors

Presenter: Richard D., Hasz, Philadelphia, United States
Authors: Gweneth O'Shaughnessy, Sharon West, Richard Hasz, Howard M. Nathan

A 17 Year Summary of One OPO's Changing Pool of Potential Donors

Gweneth O'Shaughnessy1, Sharon West1, Richard Hasz1, Howard M. Nathan1

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

PURPOSE: Study characterizes one organ procurement organization’s (OPO) evolving donor demographics and donation outcomes over a 17 year period of time.    

METHODS: Characterizing donor demographics and donation outcomes allows the OPO to understand its pool of potential donors, and align strategies/resources.  Characteristics examined:  cause of death, mechanism of death, ethnicity, gender, and age.  Outcomes examined:  organ referrals, potential donors, actual donors (brain dead and donors after circulatory death), and conversion rates (actual donors as a percentage of potential donors).   

RESULTS:

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Organ referrals among anoxic patients increased from 24% (200) of total referrals to 57% (2093) in 2012.  In 1995, anoxic potential donors represented 15% of the donor pool vs 44% of the donor pool in 2012.  Organ donors in the anoxic pool increased from 12% (27) of total donors in 1995 to 41% (171) in 2012.  DCD donors represented 46% of all DCD donors in 2012 (n = 65).  The primary mechanism of injury was cardiovascular (50% in 1995; 71% in 2012).  Conversion rates are higher in the ‘other’ cause of death category. 

CONCLUSION: There has been a dramatic increase in the overall volume of referrals, potential, and donors in the anoxic population.  These patients are typically cared for in medical/cardiac intensive care units (ICUs) vs other ICUs.  To ensure that there is an optimal donation process in place, OPOs should evaluate the impact of shifting hospital development (HD) staffing resources to these areas.  Although conversion rates in the anoxic donor pool improved to 50%, other strategies should be considered to improve consent and conversion.

Figure 1


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