Sequential improvements in organ procurement increase the organ donation rate.
OBJECTIVE
Organ demand exceeds availability of transplantable organs. Organ procurement continues to suffer from failures to identify potential donors, inability to obtain consent for donation, as well as failures to retrieve certain organs as donor demographics change. The purpose of this article is to propose how sequentially introduced measures can increase organ donation rates as well as improve organ procurement.


METHODS
We analysed the effect of stepwise improvements in the organ procurement process patients in a university-based surgical intensive care unit over a 20-year period. We related newly introduced measures in the organ retrieval process with changes in donation rates. We specifically targeted these three main steps in the donation process: donor identification, conversion of potential donors to actual donors, and organ protection during the procurement process. Finally, we assessed the effect of the same measures on organ procurement after introduction in other hospitals of the same organ procurement region.


RESULTS
Introduction of quality improvement steps increased all of the observed parameters. The number of organ donors was stabilised due to a better identification of potential donors, a major increase in conversion from potential to actual donors, and an increase in extended criteria donor. Improvements in organ protection led to higher rates of organs transplanted per donor and increased recovery of lungs and hearts despite increasing donor age. The same measures were introduced successfully in other hospitals in our organ procurement region.


CONCLUSIONS
Sequential improvements in organ procurement can increase the yield of retrieved organs. The same measures can be applied to other hospitals and lead to comparable improvements in organ donation.
Department of Surgery, Price Institute of Surgical Research, School of Medicine, University of Louisville, 511 South Floyd Street, Louisville, KY 40202, United States. adrianbilleter@bluewin.ch
Adrian T
AT
Billeter
Seth
S
Sklare
Glen A
GA
Franklin
Jerry
J
Wright
Gary
G
Morgan
Paul E
PE
O'Flynn
Hiram C
HC
Polk
D005260:Female; D006801:Humans; D033181:Information Dissemination; D007258:Informed Consent / Q000706:statistics & numerical data; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D016377:Organ Transplantation; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000458:organization & administration* / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology