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Retrieval team-initiated early donor management increases the donor heart utilization rate for transplantation

Cristina Barbero1, Antonio Ravaglioli1, Aravinda A Page1

  • 1Department of Transplantation, Royal Papworth Hospital, Papworth Everald, Cambridge, UK.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|September 22, 2018
PubMed

Insights

Early donor management by a specialized team significantly improved donor heart utilization rates. This approach also reduced operating room time, enhancing efficiency in heart transplantation procedures.

Area of Science:

  • Cardiology
  • Transplantation Medicine
  • Organ Donation

Background:

  • End-stage heart failure treatment relies heavily on heart transplantation.
  • A significant number of donor hearts are declined due to suboptimal function, exacerbating organ shortages.
  • Optimizing donor management is crucial to increase the utilization of available donor organs.

Purpose of the Study:

  • To evaluate the impact of a 'scout programme' for early donor management on donor heart utilization.
  • To assess the effectiveness of a national cardiothoracic organ retrieval team in managing potential heart donors.
  • To analyze the 2-year experience of this targeted donor management strategy.

Main Methods:

  • A prospective cohort study involving consecutive brain-dead donors from 2013 to 2015.
  • Inclusion of a cardiothoracic retrieval team member to assist with early donor management in the donor hospital's ICU.
  • Comparison of outcomes between 'scouted' (early management) and 'non-scouted' donor groups.

Main Results:

  • The donor heart utilization rate was significantly higher in the 'scouted' group (47.2%) compared to the 'non-scouted' group (30.6%) (P=0.03).
  • Early donor management by the retrieval team independently predicted increased donor heart utilization.
  • The 'scouted' group experienced a significant reduction in operating theatre time from donor heart arrival to skin incision.

Conclusions:

  • Early, targeted donor management by cardiothoracic retrieval teams substantially increases the utilization of donor hearts.
  • This proactive management strategy also leads to operational efficiencies, reducing critical time intervals in the transplant process.
Abstract

Keywords:
Brain stem deathDonor scoutEarly donor managementHeart retrievalHeart transplantOrgans donor

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