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Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death

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Potential for deceased donation not optimally exploited: donor action data from six countries.

Leo Roels¹, Jacqueline Smits, Bernard Cohen

¹Donor Action Foundation, Prinsendreef 10, B-3210 Linden, Belgium. info@donoraction.org

Transplantation

|November 2, 2012

Summary

Over half of potential deceased organ donors are missed due to identification, referral, or consent issues. Optimizing deceased donation practices is crucial to increase the organ pool alongside living donation efforts.

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Area of Science:

Organ transplantation research
Public health policy
Critical care medicine

Background:

Living organ donation is promoted globally to address organ shortages.
The effectiveness of deceased organ donation requires optimal exploitation of its potential.

Purpose of the Study:

To assess the conversion rate of potential heart-beating deceased donors into actual donors across six countries.
To identify key points of loss in the deceased organ donation pathway.

Main Methods:

Utilized the Donor Action (DA) Medical Record Review (MRR) methodology.
Analyzed data from 52,383 deceased patients across 605 critical care units in 227 hospitals (2007-2009).
Focused on ventilated patients eligible for heart-beating donation.

Main Results:

Out of 17,903 eligible patients, 4,855 were potential heart-beating donors.
On average, 24.8% were not identified, 21.9% not referred, and 11.3% not approached for donation.
The conversion rate from potential to actual donors was 42.1%, with consent rates at 69.1%.

Conclusions:

More than 57% of potential deceased organ donors were missed in the donation pathway.
Missed opportunities included non-identification, non-referral, lack of family approach, or objections.
Enhancing deceased organ donation practices is vital to increase the organ supply, complementing living donation initiatives.