Development of the University of Wisconsin donation After Cardiac Death Evaluation Tool.
BACKGROUND
Donation after cardiac death is a method by which severely neurologically injured patients not fulfilling brain-death criteria can donate organs.


OBJECTIVE
To develop an evaluation tool that can be used to predict if a patient is a suitable candidate for donation after cardiac death.


METHODS
The University of Wisconsin Donation After Cardiac Death Evaluation Tool assigns numeric values to observable clinical parameters to yield an overall predictive score of suitability for donation after cardiac death. This evaluation tool is typically utilized in a critical care unit to evaluate patients with a severe neurological injury, who do not meet brain-death criteria, and for whom the physician and family have chosen to terminally withdraw life support. Each patient is disconnected from a ventilator and observed for up to 10 minutes. Observations are then scored to yield a prediction of suitability for donation after cardiac death.


RESULTS
Using the University of Wisconsin Donation After Cardiac Death Evaluation Tool, we were able to predict suitability for donation after cardiac death 83.7% of the time, within a 60-minute period and 74.4% of the time within a 120-minute period. The actual results using the tool were higher when clinical observations were included in the donation after cardiac death evaluation--an overall accuracy of 88.4%.
Lewis
Jonathan
J
University of Wisconsin Hospital and Clinics Organ Procurement Organization, Madisin, Wis, USA.
Peltier
James
J
Nelson
Helen
H
Snyder
William
W
Schneider
Kristi
K
Steinberger
Dina
D
Anderson
Michael
M
Krichevsky
Alexander
A
Anderson
James
J
Ellefson
Jill
J
D'Alessandro
Anthony
A
D003643:Death; D003661:Decision Support Techniques; D006801:Humans; D016377:Organ Transplantation; D018579:Patient Selection; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D009927:Tissue and Organ Procurement