Achieving donor management goals before deceased donor procurement is associated with more organs transplanted per donor

Darren Malinoski, Michael C. Daly, Madhukar S. Patel, Chrystal Oley-Graybill, Clarence E. Foster, Ali Salim

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Background: There is a national shortage of organs available for transplantation. Implementation of preset donor management goals (DMGs) to improve outcomes is recommended, but uniform practices and data are lacking. We hypothesized that meeting DMGs before organ procurement would result in more organs transplanted per donor (OTPD). Methods: The eight organ procurement organization in United Network for Organ Sharing Region 5 selected 10 critical care end points as DMGs. Each organ procurement organization submitted retrospective data from 40 standard criteria donors. "DMGs met" was defined as achieving any eight DMGs before procurement. The primary outcome was ≥4 OTPD. Binary logistic regression was used to determine independent predictors of ≥4 OTPD with a p <0.05. Results: Three hundred twenty standard criteria donors had 3.6 ± 1.6 OTPD. Donors with DMGs met had more OTPD (4.4 vs. 3.3, p <0.001) and were more likely to have ≥4 OTPD (70% vs. 39%, p <0.001). Independent predictors of ≥4 OTPD were age (odds ratio [OR] = 0.94), serum creatinine (OR = 0.65), thyroid hormone use (OR = 2.0), "DMGs met" (OR = 4.4), and achieving the following individual DMGs: central venous pressure 4 mm Hg to 10 mm Hg (OR = 1.9), ejection fraction >50% (OR = 4.0), Pao2:FIO2 >300 (OR = 4.6), and serum sodium 135 to 160 mEq/L (OR = 3.4). Conclusions: Meeting DMGs before procurement resulted in more OTPD. Donor factors and critical care end points are independent predictors of organ yield. Prospective studies are needed to determine the true impact of each DMG on the number and function of transplanted organs.

Original languageEnglish (US)
Pages (from-to)990-995
Number of pages6
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume71
Issue number4
DOIs
StatePublished - Oct 2011
Externally publishedYes

Fingerprint

Tissue and Organ Procurement
Critical Care
Organ Transplantation
Logistic Models
Sodium
Prospective Studies
Serum

Keywords

  • Checklist
  • Donor management
  • Donor management goals
  • Organ donation
  • Transplantation

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Achieving donor management goals before deceased donor procurement is associated with more organs transplanted per donor. / Malinoski, Darren; Daly, Michael C.; Patel, Madhukar S.; Oley-Graybill, Chrystal; Foster, Clarence E.; Salim, Ali.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 71, No. 4, 10.2011, p. 990-995.

Research output: Contribution to journalArticle

Malinoski, Darren ; Daly, Michael C. ; Patel, Madhukar S. ; Oley-Graybill, Chrystal ; Foster, Clarence E. ; Salim, Ali. / Achieving donor management goals before deceased donor procurement is associated with more organs transplanted per donor. In: Journal of Trauma - Injury, Infection and Critical Care. 2011 ; Vol. 71, No. 4. pp. 990-995.
@article{38659ea3687a43c38aebe131a70fc79f,
title = "Achieving donor management goals before deceased donor procurement is associated with more organs transplanted per donor",
abstract = "Background: There is a national shortage of organs available for transplantation. Implementation of preset donor management goals (DMGs) to improve outcomes is recommended, but uniform practices and data are lacking. We hypothesized that meeting DMGs before organ procurement would result in more organs transplanted per donor (OTPD). Methods: The eight organ procurement organization in United Network for Organ Sharing Region 5 selected 10 critical care end points as DMGs. Each organ procurement organization submitted retrospective data from 40 standard criteria donors. {"}DMGs met{"} was defined as achieving any eight DMGs before procurement. The primary outcome was ≥4 OTPD. Binary logistic regression was used to determine independent predictors of ≥4 OTPD with a p <0.05. Results: Three hundred twenty standard criteria donors had 3.6 ± 1.6 OTPD. Donors with DMGs met had more OTPD (4.4 vs. 3.3, p <0.001) and were more likely to have ≥4 OTPD (70{\%} vs. 39{\%}, p <0.001). Independent predictors of ≥4 OTPD were age (odds ratio [OR] = 0.94), serum creatinine (OR = 0.65), thyroid hormone use (OR = 2.0), {"}DMGs met{"} (OR = 4.4), and achieving the following individual DMGs: central venous pressure 4 mm Hg to 10 mm Hg (OR = 1.9), ejection fraction >50{\%} (OR = 4.0), Pao2:FIO2 >300 (OR = 4.6), and serum sodium 135 to 160 mEq/L (OR = 3.4). Conclusions: Meeting DMGs before procurement resulted in more OTPD. Donor factors and critical care end points are independent predictors of organ yield. Prospective studies are needed to determine the true impact of each DMG on the number and function of transplanted organs.",
keywords = "Checklist, Donor management, Donor management goals, Organ donation, Transplantation",
author = "Darren Malinoski and Daly, {Michael C.} and Patel, {Madhukar S.} and Chrystal Oley-Graybill and Foster, {Clarence E.} and Ali Salim",
year = "2011",
month = "10",
doi = "10.1097/TA.0b013e31822779e5",
language = "English (US)",
volume = "71",
pages = "990--995",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Achieving donor management goals before deceased donor procurement is associated with more organs transplanted per donor

AU - Malinoski, Darren

AU - Daly, Michael C.

AU - Patel, Madhukar S.

AU - Oley-Graybill, Chrystal

AU - Foster, Clarence E.

AU - Salim, Ali

PY - 2011/10

Y1 - 2011/10

N2 - Background: There is a national shortage of organs available for transplantation. Implementation of preset donor management goals (DMGs) to improve outcomes is recommended, but uniform practices and data are lacking. We hypothesized that meeting DMGs before organ procurement would result in more organs transplanted per donor (OTPD). Methods: The eight organ procurement organization in United Network for Organ Sharing Region 5 selected 10 critical care end points as DMGs. Each organ procurement organization submitted retrospective data from 40 standard criteria donors. "DMGs met" was defined as achieving any eight DMGs before procurement. The primary outcome was ≥4 OTPD. Binary logistic regression was used to determine independent predictors of ≥4 OTPD with a p <0.05. Results: Three hundred twenty standard criteria donors had 3.6 ± 1.6 OTPD. Donors with DMGs met had more OTPD (4.4 vs. 3.3, p <0.001) and were more likely to have ≥4 OTPD (70% vs. 39%, p <0.001). Independent predictors of ≥4 OTPD were age (odds ratio [OR] = 0.94), serum creatinine (OR = 0.65), thyroid hormone use (OR = 2.0), "DMGs met" (OR = 4.4), and achieving the following individual DMGs: central venous pressure 4 mm Hg to 10 mm Hg (OR = 1.9), ejection fraction >50% (OR = 4.0), Pao2:FIO2 >300 (OR = 4.6), and serum sodium 135 to 160 mEq/L (OR = 3.4). Conclusions: Meeting DMGs before procurement resulted in more OTPD. Donor factors and critical care end points are independent predictors of organ yield. Prospective studies are needed to determine the true impact of each DMG on the number and function of transplanted organs.

AB - Background: There is a national shortage of organs available for transplantation. Implementation of preset donor management goals (DMGs) to improve outcomes is recommended, but uniform practices and data are lacking. We hypothesized that meeting DMGs before organ procurement would result in more organs transplanted per donor (OTPD). Methods: The eight organ procurement organization in United Network for Organ Sharing Region 5 selected 10 critical care end points as DMGs. Each organ procurement organization submitted retrospective data from 40 standard criteria donors. "DMGs met" was defined as achieving any eight DMGs before procurement. The primary outcome was ≥4 OTPD. Binary logistic regression was used to determine independent predictors of ≥4 OTPD with a p <0.05. Results: Three hundred twenty standard criteria donors had 3.6 ± 1.6 OTPD. Donors with DMGs met had more OTPD (4.4 vs. 3.3, p <0.001) and were more likely to have ≥4 OTPD (70% vs. 39%, p <0.001). Independent predictors of ≥4 OTPD were age (odds ratio [OR] = 0.94), serum creatinine (OR = 0.65), thyroid hormone use (OR = 2.0), "DMGs met" (OR = 4.4), and achieving the following individual DMGs: central venous pressure 4 mm Hg to 10 mm Hg (OR = 1.9), ejection fraction >50% (OR = 4.0), Pao2:FIO2 >300 (OR = 4.6), and serum sodium 135 to 160 mEq/L (OR = 3.4). Conclusions: Meeting DMGs before procurement resulted in more OTPD. Donor factors and critical care end points are independent predictors of organ yield. Prospective studies are needed to determine the true impact of each DMG on the number and function of transplanted organs.

KW - Checklist

KW - Donor management

KW - Donor management goals

KW - Organ donation

KW - Transplantation

UR - http://www.scopus.com/inward/record.url?scp=80054015939&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80054015939&partnerID=8YFLogxK

U2 - 10.1097/TA.0b013e31822779e5

DO - 10.1097/TA.0b013e31822779e5

M3 - Article

VL - 71

SP - 990

EP - 995

JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

IS - 4

ER -