Critical care and ventilatory management of deceased organ donors impacts lung use and recipient graft survival

2021 ◽  
Author(s):  
Elizabeth A. Swanson ◽  
Madhukar S. Patel ◽  
Michael P. Hutchens ◽  
Claus U. Niemann ◽  
Tahnee Groat ◽  
...  
Keyword(s):  
Critical Care ◽  
Graft Survival ◽  
Organ Donors ◽  
Ventilatory Management

scholarly journals The Effect of Inhalational Anaesthesia during Deceased Donor Organ Procurement on Post-Transplantation Graft Survival

2018 ◽  
Vol 46 (2) ◽  
pp. 178-184 ◽  
Author(s):  
S. Perez-Protto ◽  
R. Nazemian ◽  
M. Matta ◽  
P. Patel ◽  
K. J. Wagner ◽  
...  
Keyword(s):  
Graft Survival ◽  
Organ Procurement ◽  
Survival Rates ◽  
Deceased Donor ◽  
Recovery Phase ◽  
Organ Donors ◽  
Post Transplantation ◽  
Ischaemia Reperfusion Injury ◽  
Definitive Answer ◽  
Medical Histories

Many deceased by neurologic criteria donors are administered inhalational agents during organ recovery surgery—a process that is characterised by warm and cold ischaemia followed by warm reperfusion. In certain settings, volatile anaesthetics (VA) are known to precondition organs to protect them from subsequent ischaemia–reperfusion injury. As such, we hypothesised that exposure to VA during organ procurement would improve post-graft survival. Lifebanc (organ procurement organisation [OPO] for NE Ohio) provided the investigators with a list of death by neurologic criteria organ donors cared for at three large tertiary hospitals in Cleveland between 2006 and 2016—details about the surgical recovery phase were extracted from the organ donors’ medical records. De-identified data on graft survival were obtained from the United Network for Organ Sharing (UNOS). The collated data underwent comparative analysis based on whether or not VA were administered during procurement surgery. Records from 213 donors were obtained for analysis with 138 exposed and 75 not exposed. Demographics, medical histories, and organ procurement rates were similar between the two cohorts. For the primary endpoint, there were no significant differences observed in either early (30-day) or late (five-year) graft survival rates for kidney, liver, lung, or heart transplants. Our findings from this retrospective review of a relatively small cohort do not support the hypothesis that the use of VA during the surgical procurement phase improves graft survival. Reviews of larger datasets and/or a prospective study may be required to provide a definitive answer.

scholarly journals Vasopressor selection during critical care management of brain dead organ donors and the effects on kidney graft function

2020 ◽  
Vol 88 (6) ◽  
pp. 783-788
Author(s):  
Elizabeth A. Swanson ◽  
Madhukar S. Patel ◽  
Tahnee Groat ◽  
Nora E. Jameson ◽  
Margaret K. M. Ellis ◽  
...  
Keyword(s):  
Critical Care ◽  
Care Management ◽  
Graft Function ◽  
Organ Donors ◽  
Kidney Graft ◽  
Critical Care Management ◽  
Brain Dead

Critical care management of potential organ donors: our current standard

2009 ◽  
Vol 23 ◽  
pp. 2-9 ◽  
Author(s):  
C. Dictus ◽  
B. Vienenkoetter ◽  
M. Esmaeilzadeh ◽  
A. Unterberg ◽  
R. Ahmadi
Keyword(s):  
Critical Care ◽  
Care Management ◽  
Organ Donors ◽  
Current Standard ◽  
Critical Care Management

How nurses shift from care of a brain-injured patient to maintenance of a brain-dead organ donor

2001 ◽  
Vol 10 (5) ◽  
pp. 306-312 ◽  
Author(s):  
L Day
Keyword(s):  
Critical Care ◽  
Organ Procurement ◽  
Injured Patient ◽  
Organ Donor ◽  
Critical Care Nurses ◽  
Organ Donors ◽  
Early Referral ◽  
Brain Injured Patient ◽  
Brain Injured ◽  
Brain Dead

BACKGROUND: The responsibility of obtaining organs for transplantation rests partly on critical care nurses. How nurses balance care of critically ill, brain-injured patients with the professional responsibility to procure organs is a question of ethical and clinical importance. OBJECTIVES: To describe the experiences of critical care nurses in making the shift from caring for a brain-injured patient identified as a potential organ donor to maintaining a brain-dead body. METHODS: An interpretive, phenomenological design was used. In 2 trauma centers, 9 critical care nurses were interviewed, and 2 of the 9 nurses were observed. RESULTS: Identification of potential organ donors is made under conditions of prognostic ambiguity. The transition from brain injury to brain death is a period of instability in which the critical care team must decide quickly whether to resuscitate a patient in order to procure organs. After a patient is brain dead, critical care nurses' relationship with and responsibility toward the patient change. CONCLUSIONS: The process of identifying potential organ donors and holding open the tentative possibility of organ procurement illustrates the practical difficulties of early referral of potential donors to organ procurement organizations. Early referral to an organ procurement organization implies a commitment to organ procurement that some nurses may hesitate to make because such a commitment changes their relationship with a brain-injured patient.

Researching the Bereaved: an investigator’s experience

2000 ◽  
Vol 7 (1) ◽  
pp. 23-34 ◽  
Author(s):  
Magi Sque
Keyword(s):  
Critical Care ◽  
Organ Donation ◽  
Research Agenda ◽  
Personal Attributes ◽  
Organ Donors ◽  
Personal Impact ◽  
Donation Process ◽  
Major Organ ◽  
Care Situation ◽  
Research Narrative

The issues discussed in this article concern the process of interviewing the bereaved relatives of organ donors, the personal impact, and the potentially painful nature of such research. Narrative interviews were carried out with 24 donor relatives. The relatively small number of donating families and their anonymity mean that little is understood about the experience of having a relative in a critical care situation that ends in donation. The purpose of this study was to develop a theory that explained the organ donation process for relatives of ‘major organ’ donors. A central concern of implementing the investigation was the possible threat it posed to the participants and myself. The sensitive nature of the research made access to relatives difficult. Undoubtedly, my nursing background and personal attributes had an impact on interactions with participants and the pursuance of the research agenda.

scholarly journals Losing potential organ donors in critical care units: data from the Donor Action Database

Critical Care ◽  
2009 ◽  
Vol 13 (Suppl 1) ◽  
pp. P78
Author(s):  
L Roels ◽  
C Spaight ◽  
J Smits ◽  
B Cohen
Keyword(s):  
Critical Care ◽  
Organ Donors ◽  
Critical Care Units
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