A Single-Center Experience with an Intensivist-Led Brain-Dead Donor Management Program.

Area of Science:

• Intensive Care Medicine
• Transplantation
• Organ Donation

Background:

• Brain-dead donor management is critical for successful organ transplantation.
• Hemodynamic instability in brain-dead donors poses challenges to organ viability.
• The role of intensivists in optimizing donor management is increasingly recognized.

Purpose of the Study:

• To report institutional experience with dedicated intensivist management of brain-dead donors.
• To evaluate the impact of intensivist-led care on organ donation rates and outcomes.
• To advocate for a defined role for intensivists in organ donation protocols.

Main Methods:

• Retrospective review of hospital medical records and Korean Network of Organ Sharing (KONOS) data (August 2013 - December 2016).
• Management of brain-dead donors by experienced intensivists utilizing advanced monitoring and therapies.
• Data collection on donor characteristics, management strategies, and organ retrieval numbers.

Main Results:

• Fifty-four brain-dead donors were managed, representing 3.2% of nationwide data.
• Intensivist management, including pulmonary artery catheterization (87.0%) and continuous renal replacement therapy (40.7%), was sustained for an average of 2.81 days.
• The mean number of retrieved organs per donor was 3.98, exceeding the national average and comparable to global benchmarks.
• Specific organ donation numbers included: 23 hearts, 17 lungs, 102 kidneys, 47 livers, 6 pancreases, 1 pancreatic duct, and 1 small intestine.

Conclusions:

• Dedicated intensivist management significantly enhances the number of actual organ donors.
• Intensivist-led care improves the quantity and quality of harvested organs.
• Integrating intensivists into organ donation pathways optimizes resource utilization and patient outcomes.