An 81% Increase in Organ Donors from Anoxic Deaths in One OPO. (August 2017)

• Record Type: Journal Article
• Authors: Hasz, Richard; West, Sharon M.; Nathan, Howard M.
• Is Part Of: Transplantation. Volume 101(2017)Supplement 8S-2
• Publication Date: 2017-08
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation immunology -- Periodicals; 617.95
• DOI: 10.1097/01.tp.0000524983.54808.c1
• Languages: English
• ISSNs: 0041-1337

Abstract

Abstract : Introduction: Increases in drug overdoses along with increased utilization of hypothermia protocols to treat patients who have suffered cardiac arrest have expanded opportunities for organ donation when patients suffer non-recoverable anoxic injuries in the U.S. Methods: Anoxic deaths, resulting from a prolonged absence of oxygen supply to the brain, are primarily caused by cardiac arrests and drug overdoses. This study characterizes one OPO's evolving donor demographics and donation outcomes in the anoxic potential donor pool over five (5) years. Characterizing donor demographics and donation outcomes allows the OPO to understand its pool of potential donors, and align strategies/resources. Characteristics examined: volume of donor potential in the referral hospital, age, race, sex, and mechanism of death. Outcomes examined: potential donors, actual donors and conversion rates (actual donors as a percentage of potential donors referred). This OPO categorized hospitals within its service area based on annual organ donor potential (Level 1 20+, Level 2 10+, Level 3 5+, Level 4 < 5). Results: Potential organ donors from anoxic patients increased by 57% from 351 in 2012 to 550 in 2016. This represents 58% of the potential donor pool in 2016. Actual organ donors in the anoxic pool increased 81% from 171 in 2012 to 309 in 2016. Anoxic deaths increased from 36% (222/622) to 49% (352/717) of potential in Level 1 and 2 hospitals, and increased from 75% (129/173) to 87% (198/228) in Level 3 and 4 hospitals. The mean age was 48 years for cardiovascular deaths versus 32 years for drug overdoses, 63% (912/1453) of cardiovascular patients were white versus 86% (368/430) of drug overdoses, 29% (427/1453) of cardiovascular patients were donor designated versus 46% (199/430) of drug overdoses. In 2016, conversion rates were 47% (156/322) for cardiovascular deaths and 78% (119/154) for drug overdoses. Conclusion: There has been a dramatic increase in the overall volume of potential organ donors and actual organ donors in the anoxic population. A focus on educating hospital staff about when to call the OPO to evaluate patients with anoxic injuries for potential for organ donation has helped increase the donor pool. 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. Strategies should be considered to improve authorization and conversion rates for anoxic patients. Figure. No caption available.