Organ Donor Recovery Performed at an Organ Procurement Organization-Based Facility Is an Effective Way to Minimize Organ Recovery Costs and Increase Organ Yield

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• 作者：Majella Doyle ; MD ; MBA ; FACS^a ; ^{doylem@wustl.edu" class="auth_mail" title="E-mail the corresponding author} ; Vijay Subramanian ; MD^a ; Neeta Vachharajani ; MD^a ; Kelly Collins ; MD^a ; Jason R. Wellen ; MD ; MBA ; FACS^a ; Emily Stahlschmidt ; BS^b ; Diane Brockmeier ; RN ; BSN ; MA^b ; Jason Coleman ; RN ; BSN ; MBA^b ; Dean Kappel ; BA ; MSW^b ; William C. Chapman ; MD ; FACS^a
• 关键词：DBD ; donation after brain death ; DCD ; donation after cardiac death ; ECD ; expanded criteria donors ; OAC ; organ acquisition charge ; OPO ; organ procurement organization ; OR ; operating room
• 刊名：Journal of the American College of Surgeons
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：222
• 期：4
• 页码：591-600
• 全文大小：454 K

文摘

A new era in organ donation with national redistricting is being proposed. With these proposals, costs of organ acquisition are estimated to more than double. Traditionally, organ recoveries occur in the donor hospital setting, incurring premium hospital expenses. The aim of the study was to determine organ recovery costs and organ yield for donor recoveries performed at an organ procurement organization (OPO) facility.

bsSec_2">Study Design

bspara0015">In 2001, we established an OPO facility and in 2008 began transferring the donor expeditiously when brain death was declared. The OPO donor and hospital costs on a per donor basis were calculated. Donation after cardiac death donors cannot be transferred and were included in the hospital cost analysis.

bsSec_3">Results

bspara0020">From January 2009 to December 2014, nine hundred and sixty-three donors originating in our OPO had organs recovered and transplanted. Seven hundred and sixty-six (79.5%) donors were transferred to the OPO facility 8.6 hours (range 0.6 to 23.6 hours) after declaration of brain death. Donor recovery cost was 51% less when donors were transferred to the OPO facility ($16,153 OPO recovery vs $33,161 hospital recovery; p < 0.0001). Organ yield was 27.5% better (3.43 organs) from OPO-recovered donors vs an organ yield of 2.69 from hospital-recovered donors (p < 0.0001). Standard criteria donor organ yield from our OPO was 6% higher than the national average (3.92 vs 3.7 nationally; p = 0.012) and expanded criteria donor organ yield was 18% higher (2.2 vs 1.87 nationally; p = 0.03).

bsSec_4">Conclusions

bspara0025">An OPO facility for donor organ recovery increases efficiency and organ yield, reduces costs, and minimizes organ acquisition charge. As we face new considerations with broader sharing, increased efficiencies, cost. and organ use should be considered.