Better communication between intensive care physicians and organ procurement coordinators could increase the availability of lungs and kidneys for transplant, research by the University of Pittsburgh Medical Center and the university's medical school shows.
More than twice as many lungs and nearly 50 percent more kidneys could be recovered for transplantation if ICU physicians and organ procurement coordinators worked together to monitor and manage the bodies of brain dead donors.
"Our analysis shows that an intensivist at the donor's bedside who aids and advises the organ procurement (OP) coordinator can result in a greater likelihood of recovering organs that are deemed acceptable for transplant, said lead author Kai Singbartl, M.D. Singbartl is assistant professor of critical care medicine at the University of Pittsburgh School of Medicine and a UPMC intensivist.
In 2008, UPMC Presbyterian implemented an intensivist-led organ donor support team to work with the OP coordinator at the bedside of brain dead donors. Standard protocols to maintain tissues and organs for transplant are supported by physician interventions, including adjustments to optimize oxygenation, and to balance blood pressure and flow, fluids, and other bodily functions to sustain as many organs as possible for transplant.
Data from adult brain dead donors between July 1, 2008 and June 30, 2009 was compared to data from July 1, 2007 to June 30, 2008, before the organ donor support team approach was used. In the earlier time period, 31% of potentially available organs were transplanted. Using the support team, transplants increased to 44% of available organs.
Data showed that the organ donor support team produced a 200% increase in transplanted lungs and almost a 50% increase in transplanted kidneys. Heart and liver transplantation rates did not register a significant change.
Researchers credit the conversion of medically unsuitable donors into actual donors, better resuscitation of unstable donors, optimization of organ function, and improved communication between the organ procurement staff, ICU team and transplant surgeons as contributing to the increased transplantation rates.
Dr. Singbartl cautioned that "the number of donors in our study is not large enough to determine whether a particular medical intervention played a key role, but it's very clear from our experience that this team approach did make a difference."
The analysis appears in the online version of the American Journal of Transplantation.
Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
