The tracks are color-coded to help you navigate the abstracts more easily.
Administrative, Authorization, Clinical, Development, Leadership,
PE/PR, Technology/Science/Data, Tissue/CC/Forensic-Funeral Home
Effects of 16-Plus-Hour Prone Ventilation on Lung Donations in Organ Donors with Death by Neurological Criteria
Standardized Fluid Resuscitation Without Advanced Hemodynamic Monitoring
Increasing Donor Lung Yield; A Systematic Approach to Increase Placement of Less Optimal Lungs
Won't You Be My Neighbor: How Strong Regional Relationships Increase Organ Transplantation Rates for a Mass-Exporter OPO
Abusive Head Trauma Victims As Organ Donors: A Ten-Year Retrospective Review of Georgia Organ Procurement Organization and Medical Examiner Office
90 Day Heart Valve: How an Enterprise Wide Approach Drove a 63% Increase in Heart Valve Donation
A Comparison of Stroke Volume Measurement by Esophageal Doppler and Flotrac During a Fluid Resuscitation Protocol in Brain-Dead Organ Donors; A Randomized Trial
Concurrent Acceptances Associated with Decreased Deceased Donor Liver Utilization
Does Intensivist Management of Organ Donors with Death by Neurologic Criteria Result in Increased Organ Yield?
Doubling the Number of DCD Donors in a Year; a Multi-Departmental Collaboration
Elimination of Donation after Cardiac Death Evaluation Tool Maximizes Pool of Available Organs
Donor Hero Camp for Donor Family Children
Freedom to Give
Gift of Life Summit: Creating Task Forces in All Communities by Connecting the Coroner, DMV, Ambassadors and Hospitals
Hospital Based Peer to Peer Feedback and Reduction in Process Issues
Healthy Heart, Third Life: An OPO Perspective on Retransplantation
Hospital Donation after Circulatory Death (DCD) Team
Impact of ED and ICU Nurse Donor Champion Training Program on Donor Conversion Rates and Nursing Knowledge: A Quality Improvement Project
Implementation of Electronic Health Record Organ Clinical Triggers can Save Lives
Leveraging Technology to Incorporate Life-Saving Triggers in the Health System Electronic Medical Record
Improving Donation Outcomes through Donor Nurse Champions
Maximizing Potential Through Early Surgical Center Transfers
Top Performer Philosophy
Transplantation Science Traveling Trunk
Virtual ICU Contributes to RN-OPC Resilience and Quality Performance Outcomes
Mission Impact: Decreasing the Gap Between Actual and Potential Donors
Save 8 Today
Partners in Improvement: Resources for Common Problems
Pause, Breathe, Donate: A conversation to bring Opportunity and Hope
Determining a Reliable Way to Capture all Kidney Anatomical Errors and Determine an Accurate Error Rate.
Strongyloides Testing on Solid Organ Donors: Three Organ Procurement Organizations’ (OPOs) Experience with Standardized Testing Implementation
Simplifying=Success: Development of a Coroner/ME Dashboard facilitates huge Autopsy Report Collection Process Improvement
Autonomy or Deference? Organ Donation Decision-making among Asian Americans
Gerard P. Alolod, Director of Research Operations, College of Public Health, Temple University
Laura A. Siminoff, Dean, College of Public Health, Temple University
Heather M. Gardiner, Associate Professor, College of Public Health, Temple University
Purpose: Asian Americans (AAs) have the lowest rates of organ donation despite substantial transplantation needs. Drawing on focus groups (n=68) and a national survey (n=917), this presentation reports on the largest study to date about AAs’ attitudes and knowledge about organ donation. The findings will be incorporated into a culturally relevant pilot intervention for increasing awareness and promoting donor registration.
Methods: Local Asian community organizations and Community Advisory Board guided recruitment for this mixed-method study. Nine focus groups (FGs) were conducted and audio-recorded in Chinese, English, and Vietnamese by trained moderators with native language fluency. Recordings were transcribed and a codebook developed. Coding used the constant comparison method. Content analysis was conducted using MAXQDA. FG results informed the development and dissemination of a national survey. A Qualtrics panel provided the sample and participants invited to participate. The sampling design was to match participants’ ethnicity, education, and age with presentation of Asian populations in the U.S. Census. Descriptive, univariate, and bivariate statistics were generated using SAS 9.4.
Results: Analysis of the focus groups revealed 6 themes: positive views about organ donation, previous exposure to organ donation, primacy of the family, mistrust of the healthcare and donation systems, religious and cultural beliefs concerning the body, and isolation from mainstream American society. Unique beliefs among AAs included familial influence, religious and cultural concerns regarding body wholeness and the afterlife, and underlying reasons for medical mistrust, such as a belief in a black market in Asia. The National Survey results reinforced key FG themes. Over half (58.8%) of participants would be willing to donate organs upon death; 20.9% were undecided and would defer to their families; and 20.3% were unwilling. Willingness derived from altruistic reasons (74.1%), while those unwilling were concerned about body wholeness (30.1%). When asked specifically about decision-making about organ donation, most participants preferred their spouse or parents to make the decision for them, while only 6.7% would want to decide for themselves. Respondents were concerned about their parents’ disapproval of being an organ donor (42.3%) or reported that organ donation was a disrespectful to their parents (38.5%).
Conclusion: The study’s findings challenge the dominant educational and awareness campaigns about organ donation decision-making that focus on individual autonomy and overlook the need for incorporating specific content and messaging that address Asian Americans’ values, beliefs, and concerns
Development of a Critical Care Advisory
Katie McKee, Partner Relations and Family Aftercare Manager, LifeSource
Susan Mau Larson, Director, Partner & Community Relations, LifeSource
Purpose: The life-saving work, hope and healing of donation depend on exceptional patient care and the strongest partnership with Critical Care. The LifeSource Critical Care Advisory for Donation has two broad purposes: expert guidance and advocacy leadership.
Methods: An opportunity to establish stronger ties with Critical Care physician leaders led to the establishment of a DSA-wide Advisory. Four steps led to the formation: 1. Adoption of a charter 2. Identification of a physician leader 3. Invitations sent to 25 physicians from hospitals with active organ donation programs. 4. 18 physicians accepted. Through virtual discussion and annual meetings, the Advisory offers: EXPERT GUIDANCE • Provide input on pre-donor critical care endpoints in support of donation opportunities • Share insights on research proposals • Review and endorse donation education for physicians • Help develop hospital policy related to donation • Assist and guide decision-making in instances of difficult donor management or support • Serve as a resource for physician colleagues on donation questions ADVOCACY LEADERSHIP • Promote physician donation education within hospitals • Promote physician ownership of donation initiatives • Achieve industry innovation through discussion about advances in the field of donation and the role our donor service area hospitals might play • Consider attending regional and national forums to promote donation
Results: The inaugural Critical Care Advisory meeting was held in September 2019 in conjunction with the Alliance National Donor Management Summit. Between September and year-end 2019, the Advisory achieved the following: • Developed and endorsed honor walk resources • Informed DCD process refinement • Provided guidance on a request fora family-driven discussion about anesthesia in the OR • Initiation of a pilot for OPO family support coordinators to be present for all end of life discussions at a major hospital. • Provided insight to inform our OPO’s 2020 strategic plan priorities. A next step is engagement of several Critical Care Advisory physicians to guide content and participate in the filming of video vignettes to serve as real-time resources for introducing OPO staff.
Conclusion: The initiation of a Critical Care Advisory has confirmed interest among Critical Care physicians and strong engagement. By the AOPO annual meeting we will be able to share donation process changes and real-time support resulting from the first eight months of guidance and leadership from this group.
Maximizing Brain Death Donation; One OPO's Experience
Christine Radolovic, Director, Transplant Coordinator Services, Gift of Life Donor Program
Richard Hasz, Vice President, Clinical Services
Brittany K Lyons, Advanced Practice Coordinator
Sharon M West, Director Data & Transplant Analytics
Howard M Nathan, President & CEO
Purpose: Hospital care teams routinely discuss the withdrawal and limitation of life-sustaining therapies with next-of-kin (NOK) as part of end-of-life care. OPOs must collaborate with these teams to ensure that all families are provided with the opportunity to donate their loved one's organs and that the maximum number of organs are transplanted once authorization is obtained.
Methods: Donation outcomes were analyzed retrospectively for 3,792 medically suitable, ventilator-dependent patients referred to the OPO between 1/1/2017 and 4/30/2019. An OPO transplant coordinator (TC) collaborated with the hospital care team to determine the optimal time to initiate the donation conversation with NOK. When approached before pronouncement, the TC asked the family for additional time to allow for their loved one to progress to brain death based on the severity of the injury and the likelihood that the patient would progress.
Results: NOK was approached after pronouncement of brain death in 762 (20%) cases, and was approached before pronouncement of brain death in 3,030 (80%) cases. An OPO TC asked NOK for additional time in 1,393 cases when the patient was not brain dead but likely to progress. Of those asked, 518 (37%) NOK granted the time requested, 177 patients progressed to brain death and 171 went on to become DBD donors.
Conclusion: When NOK decide to withdraw life-sustaining therapies for a patient who is not brain dead, the OPO should advocate for more time to allow the patient to progress to brain death in order to maximize the number of organs that can be recovered for transplant.
Organ Donation in a Non-Intubated VV ECMO patient: A Case Study
Allison J. Boyer, Organ Information Specialist, LifeShare of Oklahoma
Bradon Nave, Manager of Organ Recovery, LifeShare of Oklahoma
Jeff P. Orlowski, CEO and President, LifeShare of Oklahoma
Dr. Ronald A. Squires, Medical Director, LifeShare of Oklahoma
Clinton A. Hostetler, VP of Clinical Operations, LifeShare of Oklahoma
Purpose: This case study highlights an underserved population of potential DCD donors.
Methods: Case study of a VV ECMO patient on the lung transplant list who deteriorated prior to transplant resulting in family electing to withdraw life-sustaining therapies.
Results: Case study reports the transplantation of two kidneys from a 55-year-old man with a primary medical history of Idiopathic Pulmonary Fibrosis. He was undergoing evaluation for a lung transplant when he suddenly deteriorated requiring VV ECMO and intubation. Although he was able to be extubated after 20 days, he was continuing to require VV ECMO. He and his family made the decision not to reintubate and to withdraw life sustaining therapy. The family knew his prior wish to be an organ donor and communicated this with hospital staff in their end-of-life discussions. The OPO and hospital worked collaboratively with the family to honor their wishes to withdraw life-sustaining therapy and attempt organ donation. The patient was ultimately moved to a PACU where VV ECMO was discontinued and comfort medications were provided per the hospital’s normal protocol. He declined to asystole 11 minutes after discontinuation of ECMO and was pronounced dead after the standard five-minute observation period. Both kidneys were procured and were able to be transplanted into two recipients within our DSA without complications at the time of abstract submission. DCD has expanded the pool of potential organ donations and has become increasingly common in this OPO. Year to date (12/5/2019) we have recovered 74 DCD donors representing 41% of all donors. In 2018, 56 DCD donors accounted for 30% of the deceased organ donors and in 2017, 72 DCD donors accounted for 38% of the deceased organ donors in our DSA. These numbers continue to grow, while maintaining a stable brain-dead heart beating donor volume.
Conclusion: This case study describes the opportunity for patients who are not mechanically ventilated but are receiving other life-sustaining measures to become deceased organ donors. The OPO has a high conversion rate of what would be considered “traditional” DCD donation candidates. A focused effort is being initiated to capture an increased number of “non-traditional” DCD candidates. It is our hope by publishing this study that other OPO’s will collaborate with their donor hospitals to expand the criteria for organ referrals and evaluate their current hospital services and screening practices. We believe this population represents a significant opportunity to save and heal more lives of waiting recipients.
Virtual ICU Contributes to RN-OPC Resilience and Quality Performance Outcomes
Eric Pahl, CTO, Head of Research and Development, OmniLife
Purpose: Thousands of viable organs are discarded every year with incorrect or inappropriate reasons for declination. One limitation on the accessibility of organ transplantation is the time-sensitive, onerous, and disorganized determination of donor/recipient match quality. Misconstrued decline reasons are not helpful when analyzing retrospectively or constructing quality improvement programs for transplant centers and organ procurement organizations.
Methods: A Plan-Do-Study-Act performance improvement methodology was utilized to design and implement a dedicated mobile communication application (app). Procurement and transplant teams in Iowa and the D.C. area analyzed critical time points in the organ offer, procurement, and transplant processes on a monthly basis while implementing the app. The report of organ offers was supplemented with the documentation of real-time communication.
Results: Teams reported enhanced quality of their monthly retrospective review of the report of organ offers when supplemented with real-time documentation. Transplant and procurement directors reported that they received a detailed, unbiased, and factual account of what had transpired during each organ offer. Teams highlighted that having real-time documentation was particularly useful for organ offers that were declined inappropriately or transplanted with complications.
Conclusion: The transplant administrators substantiated the need for center-wide organ acceptance standards and processes. The extra delineation resulted in increased buy-in from clinical teams. This study is ongoing.