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. 2020 Apr;34(4):e13826.
doi: 10.1111/ctr.13826. Epub 2020 Mar 6.

Disparities in DCD organ procurement policy from a national OPO survey: A call for standardization

Ankur Pranjal Choubey  1 , Eric J Siskind  2 , Alex C Ortiz  3 , Mehdi Nayebpour  4 , Naoru Koizumi  4 , Paul Wiederhold  5 , Jorge Ortiz  1
Affiliations

Disparities in DCD organ procurement policy from a national OPO survey: A call for standardization

Ankur Pranjal Choubey et al. Clin Transplant. 2020 Apr.

Abstract

Introduction: Procurement practices across organ procurement organizations (OPOs) for donation after cardiac death (DCD) transplants have not been evaluated.

Methods: A national telephone survey of all 58 OPOs inquiring about their procurement practices of DCD organs was conducted. Policies concerning maximum donor body mass index (BMI), location of care withdrawal, pre-mortem heparin administration, vasodilator use, wait times after declaration of death before incisions, inclinations between rapid laparotomy and pre-mortem cannulation, and maximum time before aborting DCD procurement were queried.

Results: The survey revealed substantial differences across OPOs. Donor BMI restriction was considered by 36 of 58 OPOs, and 23 sites preferred OR for donor withdrawal of care. Pre-mortem heparin was utilized by 53 OPOs. Only 2 recommended vasodilators. Minimum wait time of 5-minutes was implemented by 41 OPOs. Rapid laparotomy was preferred by 57 organizations. 28 OPOs had a 90-minute limit before aborting DCD procurement.

Conclusion: There are substantial variations across OPO protocols for procuring DCD organs. Current practices do not conform to ASTS guidelines for DCD procurement. Further investigations are needed to quantify the impact of OPO policies on transplant outcomes.

Keywords: asystolic waiting time; pre-mortem cannulation; rapid laparotomy; vasodilators; warm ischemic time.

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References

REFERENCES

    1. Northup PG, Intagliata NM, Shah NL, Pelletier SJ, Berg CL, Argo CK. Excess mortality on the liver transplant waiting list: unintended policy consequences and model for End-Stage Liver Disease (MELD) inflation. Hepatology. 2015;61(1):285-291.
    1. Kollmann D, Sapisochin G, Goldaracena N, et al. Expanding the donor pool: donation after circulatory death and living liver donation do not compromise the results of liver transplantation. Liver Transpl. 2018;24(6):779-789.
    1. Wang JH, Skeans MA, Israni AK. Current status of kidney transplant outcomes: dying to survive. Adv Chronic Kidney Dis. 2016;23(5):281-286.
    1. Waki K, Kadowaki T. An analysis of long-term survival from the OPTN/UNOS pancreas transplant registry. Clin Transpl. 2007;2:9-17.
    1. National Data - OPTN. https://optn.transplant.hrsa.gov/data/view-data-reports/national-data/#. Accessed October 12, 2018.

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