Impact of compliance with the American College of Surgeons trauma center verification requirements on organ donation-related outcomes

Darren J. Malinoski, Madhukar S. Patel, Stephanie Lush, M. Lynn Willis, Sonia Navarro, Danielle Schulman, Tasha Querantes, Ramona Leinen-Duren, Ali Salim

    Research output: Contribution to journalArticle

    15 Scopus citations

    Abstract

    Background: In order to maximize organ donation opportunities, the American College of Surgeons (ACS) requires verified trauma centers to have a relationship with an organ procurement organization (OPO), a policy for notification of the OPO, a process to review organ donation rates, and a protocol for declaring neurologic death. We hypothesized that meeting the ACS requirements will be associated with improved donation outcomes. Study Design: Twenty-four ACS-verified Level I and Level II trauma centers were surveyed for the following registry data points from 2004 to 2008: admissions, ICU admissions, patients with a head Abbreviated Injury Score < 5, deaths, and organ donors. Centers were also queried for the presence of the ACS requirements as well as other process measures and characteristics. The main outcomes measure was the number of organ donors per center normalized for patient volume and injury severity. The relationship between center characteristics and outcomes was determined. Results: Twenty-one centers (88%) completed the survey and referred 2,626 trauma patients to the OPO during the study period, 1,008 were eligible to donate, and 699 became organ donors. Compliance with the 4 ACS requirements was not associated with increased organ donation outcomes. However, having catastrophic brain injury guidelines (CBIGs) and the presence of a trauma surgeon on a donor council were associated with significantly more organ donors per 1,000 trauma admissions (6.3 vs 4.2 and 6.0 vs 4.2, respectively, p < 0.05). Conclusions: Although the ACS trauma center organ donation-related requirements were not associated with improved organ donor outcomes, involvement of trauma surgeons on donor councils and CBIGs were and should be encouraged. Additionally, incorporation of quantitative organ donation measures into the verification process should be considered.

    Original languageEnglish (US)
    Pages (from-to)186-192
    Number of pages7
    JournalJournal of the American College of Surgeons
    Volume215
    Issue number2
    DOIs
    StatePublished - Aug 1 2012

    Keywords

    • ACS
    • AIS
    • Abbreviated Injury Score
    • American College of Surgeons
    • CBIG
    • DCDD
    • DNDD
    • OPO
    • catastrophic brain injury guideline
    • donation after cardiac death
    • donation after neurologic determination of death
    • organ procurement organization

    ASJC Scopus subject areas

    • Surgery

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