title: Improving Donor Conversion Rates at a Level One Trauma Center: Impact of Best Practice Guidelines.
abstract: BACKGROUND
  Organ availability is a consistently limiting factor in transplant surgery. A primary driver of this limitation is donor conversion rate, which is defined as the percentage of eligible donors for whom procurement is actually performed. An alternative way to increase organ availability is through improved utilization of organs from donors after cardiac death (DCD). Recently, a concerted, multidisciplinary effort has been made within our system to improve conversion rates and DCD utilization, thus increasing organ availability.
  
  
  METHODS
  Retrospective analysis of a prospectively collected database from TransLife, our local organ procurement organization (OPO), as well as the Orlando Regional Medical Center (ORMC) trauma registry, from 2009-2012 (up to 2013 for DCD). During which time, this organization implemented best practice guidelines to improve conversions and DCD utilization. We analyzed yearly conversion rates, DCD donations and population demographics before and after implementation of these policies.
  
  
  RESULTS
  During the study period, donor conversion rates significantly improved from 58% in 2009 to 82% percent in 2012 hospital-wide (P<0.05); and from 50% in 2009 to 81% in 2012 among trauma patients alone (P<0.05). In addition, total organs transplanted increased from 13 to 31 organs (P<0.05) after implementation of best practice guidelines. No significant differences in trauma population demographics were noted during the study period.
  
  
  CONCLUSIONS
  Based on our experience, the establishment of best practice policies for referral of potential donors, coupled with programs to educate hospital staff on the existence and importance of these policies, leads to significant improvement in donor conversion rates and increased utilization of DCD donors.
authors.affiliation: Surgical Critical Care, Cedars-Sinai Medical Center.
authors.forename: Rodrigo F
authors.initials: RF
authors.lastname: Alban
authors.affiliation: Department of Surgical Education, Orlando Regional Medical Center.
authors.forename: Bobby L
authors.initials: BL
authors.lastname: Gibbons
authors.affiliation: TransLife Organ Procurement Organization, Orlando Regional Medical Center.
authors.forename: Vanessa L
authors.initials: VL
authors.lastname: Bershad
keywords: donation champion training; donor conversion rate; organ donation; organ donors; organ procurement organization; transplant surgery