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• W4313232727 abstract "Introduction: In the US over 100,000 patients with organ failure await lifesaving organ transplantation. Brain dead donors (BDD) are the major source of organs for transplantation. Two factors in the BDD impact the number of organ available for transplantation: unmodifiable acute or chronic disease, and modifiable acute organ dysfunction. On declaration of brain death and authorization for donation, Organ Procurement Organization (OPO) personnel assume care of the BDD. Malinoski and colleagues developed a checklist of critical care end points called Donor Management Goals (DMG) which are nine physiologic parameters with specified target ranges. The DMG bundle is met when 7/9 of the endpoints are attained. DMG are typically assessed at four time points: referral to the OPO, after authorization and brain death declaration, organ allocation and prior to surgical recovery. Our goal was to study the impact of critical care management in the during the hospital phase of management before OPO involvement. Methods: We reviewed aggregate deidentified data from the National Donor Management Goals Single Page OPO Donor Report for the period from January 1, 2021, to July 21, 2022. The objective was to determine the extent of DMG bundle achievement by critical care teams in donor hospitals during the hospital phase of management (time of referral to start of case). The cohort included 2293 BDD. The number of donors achieving the DMG bundle and the OTPD at referral and consent were evaluated. Results: Donor median age was 39 years (range 0-83), 62% were male. When the DMG bundle was met at referral (n=294), OTPD was 3.50. When the DMG bundle was met after authorization and BDD (n=454), OTPD was 3.89. Where the DMG bundle was not met at referral (n=2847), OTPD was 2.88. When the bundle was not met after authorization and BDD, OTPD was 3.19. These results are consistent with those reported by Patel et al. (1) Conclusions: Critical care clinicians by optimizing physiologic endpoints in catastrophically brain injured patients improve chances of patient survival. For those patients that progress to brain death status, having achieved the DMG bundle prior to the OPO phase of donor management, should materially increase OTPD and potentially impact the national shortage of organs available for transplantation." @default.
• W4313232727 created "2023-01-06" @default.
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• W4313232727 date "2022-12-15" @default.
• W4313232727 modified "2023-10-18" @default.
• W4313232727 title "1278: MANAGEMENT OF PATIENTS WHO PROGRESS TO BRAIN DEATH AND ITS IMPACT ON ORGANS TRANSPLANTED PER DONOR" @default.
• W4313232727 doi "https://doi.org/10.1097/01.ccm.0000910848.49178.58" @default.
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