SPOTLIGHT ON EDUCATION: Trends in Extended Donor Management Times
As the number of patients on the transplant waiting list continues to grow, unfortunately the number of organ donors is not keeping pace. With an emphasis on improving donor outcomes, we have learned that stability can be maintained for 48-72 hours or longer with appropriate interventions. This could lead to thousands more saved lives.
Years ago, the mindset was that a brain dead donor’s hemodynamic status was always unstable and organ donation must occur soon after the pronouncement of death or risk the donor’s heart would arrest.
With a focus on improving donor outcomes, we have learned that stability can be maintained for 48-72 hours or longer with appropriate interventions.
The initial insult on organ systems after a catastrophic brain injury is significant. However, if through collaboration of Finger Lakes Donor Recovery Network (FLDRN) and the healthcare team we are able to stabilize the donor for 24-48 hours after brain death, often some organ systems may return to baseline and regain transplant potential.
Lung Recruitment: FLDRN’s Primary Target When Extending Donor Management Time
By improving aeration with a variety of vent settings and treating with appropriate antibiotics, we have had a number of donors who have had a significant increase in oxygenation.
As FLDRN continues to refine our process and work closely with lung transplant centers and donor hospitals in matching donor lungs – providing information that is most helpful when trying to decide if the lungs are a good match for their potential recipients – we expect to see a significant improvement in the success rate of lungs being transplanted.
As of July 2014, nearly 1,700 people were awaiting a lung transplant.
Extending Donor Management Times: Ability to Save Thousands of Transplantable Organs
The trend in extending donor management times is an important and much needed step in helping to save more lives through transplantation.
To put this into perspective, the difference of transplanting four organs from each donor within the United States instead of three would amount to approximately 8,000 more transplantable organs each year, thereby saving thousands of more lives.
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