Journal article
A Step toward Standardization: Results of two National Surveys of Best Practices in Donation after Circulatory Death Liver Recovery and Recommendations from The American Society of Transplant Surgeons and Association of Organ Procurement Organizations
Clinical transplantation, Vol.34(10), pp.e14035-n/a
10/2020
DOI: 10.1111/ctr.14035
PMID: 32654227
Abstract
Donation after circulatory death (DCD) liver allografts remain underutilized. Inconsistent processes for DCD procurement may contribute to allograft discard. Optimal surgical and organ procurement organization (OPO) practices for DCD liver recovery should be developed and adopted. DCD practice surveys were distributed to transplant surgeons and OPO leadership. DCD liver recovery best practices were assembled based on survey data, literature review, and subject-matter expert consensus opinion. Data were obtained from transplant surgeons (n = 188) and OPO leadership (n = 48 OPOs). Surgeons preferred attending physician presence at recovery (72.4%); while only 27.7% of OPOs require this. Pre-withdrawal communication huddle (Surgeons: 88.7%; OPOs: 93.8%) and administration of pre-withdrawal heparin (Surgeons: 90.6%; OPOs: 84.8%) are widely accepted. Surgical preference for withdrawal of support is in the operating room (89.3%); OPO practice varies dependent upon hospital and family requirements. Functional donor warm ischemic time (fDWIT) start time is variable, while fDWIT end time is agreed upon as initiation of aortic flush by surgeons (81%) and OPOs (81%). DCD liver recovery practices including mandatory communication huddle, pre-withdrawal heparin administration, and clearly defined start and end of fDWIT should be implemented nationally. Creating a set of best practices for DCD recovery guidelines is necessary for improving DCD liver utilization.
Details
- Title: Subtitle
- A Step toward Standardization: Results of two National Surveys of Best Practices in Donation after Circulatory Death Liver Recovery and Recommendations from The American Society of Transplant Surgeons and Association of Organ Procurement Organizations
- Creators
- Mark J Hobeika - Methodist HospitalRobert Glazner - Donor Network of Arizona Phoenix AZ USADavid P Foley - University of Wisconsin–MadisonSteven Hanish - The University of Texas Southwestern Medical CenterGeorge Loss - Department of Surgery Oschner Clinic Foundation New Orleans Louisiana USACristiano Quintini - Cleveland ClinicElling Eidbo - Association of Organ Procurement OrganizationsCharles ZollingerJay Ruterbories - Donor Alliance Denver CO USADaniel J Lebovitz - Akron Children's HospitalDavid Axelrod - Roy J. and Lucille A. Carver College of Medicine
- Resource Type
- Journal article
- Publication Details
- Clinical transplantation, Vol.34(10), pp.e14035-n/a
- DOI
- 10.1111/ctr.14035
- PMID
- 32654227
- ISSN
- 0902-0063
- eISSN
- 1399-0012
- Language
- English
- Date published
- 10/2020
- Academic Unit
- Surgery
- Record Identifier
- 9984322825802771
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