title: Clinical results of an organ procurement organization effort to increase utilization of donors after cardiac death.
abstract: BACKGROUND
  To stimulate organ donation, an organ procurement organization (OPO)-wide effort was undertaken to increase donors after cardiac death (DCD) over a 5-year period. This included commonality of protocols, pulsatile perfusion of kidneys, centralization of data and a regional allocation variance designed to minimize cold ischemia times and encourage adoption of DCD protocols at transplant centers.
  
  
  RESULTS
  In one OPO, eight centers initiated DCD programs in 11 hospitals. A total of 52 DCD donors were procured, increasing from four in 1999 to 21 in 2003. Eleven donors had care withdrawn in the operating room, whereas 41 had care withdrawn in the ICU. In all, 91 patients received renal transplants from these 52 donors (12 kidneys discarded, one double transplant), whereas 5 patients received liver transplants. One-, two-, and three-year kidney graft survival rates were 90%, 90%, and 82%, respectively. Fifty-five percent of patients needed at least one session of hemodialysis postoperatively. Mean recipient hospital length of stay was 11.1+/-6 days. Mean creatinine levels at 3, 6, 12, and 24 months were 1.65, 1.40, 1.41, and 1.40, respectively.
  
  
  CONCLUSIONS
  DCD donors can be an important source of donor organs and provide excellent overall outcomes. Regional cooperation and a prospectively considered allocation and distribution system are important considerations in stimulating DCD programs.
authors.affiliation: Department of Surgery, Maine Medical Center, Portland, 04102, USA. whitij@mmc.org
authors.forename: James F
authors.initials: JF
authors.lastname: Whiting
authors.forename: Francis
authors.initials: F
authors.lastname: Delmonico
authors.forename: Paul
authors.initials: P
authors.lastname: Morrissey
authors.forename: Giacomo
authors.initials: G
authors.lastname: Basadonna
authors.forename: Scott
authors.initials: S
authors.lastname: Johnson
authors.forename: W David
authors.initials: WD
authors.lastname: Lewis
authors.forename: Richard
authors.initials: R
authors.lastname: Rohrer
authors.forename: Kevin
authors.initials: K
authors.lastname: O'Connor
authors.forename: James
authors.initials: J
authors.lastname: Bradley
authors.forename: Tammy D
authors.initials: TD
authors.lastname: Lovewell
authors.forename: George
authors.initials: G
authors.lastname: Lipkowitz
mesh_terms: D000328:Adult; D003643:Death; D006801:Humans; D016030:Kidney Transplantation / Q000706:statistics & numerical data; D008875:Middle Aged; D014019:Tissue Donors / Q000600:supply & distribution*; D020858:Tissue and Organ Harvesting / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D009927:Tissue and Organ Procurement / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data