title: Donor management parameters and organ yield: single center results.
abstract: BACKGROUND
  Management of organ donors in the intensive care unit is an emerging subject in critical care and transplantation. This study evaluates organ yield outcomes for a large number of patients managed by the Indiana Organ Procurement Organization.
  
  
  METHODS
  This is a retrospective review of intensive care unit records from 2008-2012. Donor demographic information and seven donor management parameters (DMP) were recorded at admission, consent, 12 h after consent, and before procurement. Three study groups were created: donors meeting 0-3, 4, or 5-7 DMP. Active donor Organ Procurement Organization management began at consent; so, data analysis focuses on the 12-h postconsent time point. Outcomes included organs transplanted per donor (OTPD) and transplantation of individual solid organs.
  
  
  RESULTS
  Complete records for 499 patients were reviewed. Organ yield was 1415 organs of 3992 possible (35%). At 12 h, donors meeting more DMP had more OTPD: 2.2 (0-3) versus 3.0 (4) versus 3.5 (5-7) (P < 0.01). Aggregate DMP met was significantly associated with transplantation of every organ except intestine. Oxygen tension, vasopressor use, and central venous pressure were the most frequent independent predictors of organ usage. There were significantly more organs transplanted for donors meeting all three of these parameters (4.5 versus 2.7, P < 0.01).
  
  
  CONCLUSIONS
  Initial DMP met does not appear to be a significant prognostic factor for OTPD. Aggregate DMP is associated with transplantation rates for most organs, with analysis of individual parameters suggesting that appropriate management of oxygenation, volume status, and vasopressor use could lead to more organs procured per donor.
authors: Transplant Division, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
authors: George Ryne
authors: GR
authors: Marshall
authors: Transplant Division, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana. Electronic address: rmangus@iupui.edu.
authors: Richard S
authors: RS
authors: Mangus
authors: Transplant Division, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
authors: John A
authors: JA
authors: Powelson
authors: Transplant Division, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
authors: Jonathan A
authors: JA
authors: Fridell
authors: Transplant Division, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
authors: Chandrashekhar A
authors: CA
authors: Kubal
authors: Transplant Division, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana.
authors: A Joseph
authors: AJ
authors: Tector
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D006801:Humans; D007196:Indiana; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units / Q000458:organization & administration*; D016015:Logistic Models; D008499:Medical Records; D008875:Middle Aged; D016377:Organ Transplantation; D012189:Retrospective Studies; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000458:organization & administration*; D055815:Young Adult
keywords: Critical care; Donor management parameters; Intensive care unit; Organ donor; Transplantation