31-P

Abstract

With the recent consolidations of blood centers and the move to centralization of testing laboratories, locating FDA-licensed infectious disease laboratories willing to perform STAT testing is becoming a challenge for organ procurement organizations (OPOs). For OPOs, time is the major driver to successful procurement and transplantation. Due to the push in blood management practices, the local blood center made the decision in October, 2012 to outsource donor infectious disease testing. Testing was sent to a national laboratory in January and February, 2013. Concurrently, Midwest Transplant Network (MTN) reached out to the current FDA-licensed testing manufacturers to evaluate options of bringing testing in-house for approximately 350 donors/year. After review of instrumentation and cost per test, two of the four vendors were selected that best fit the needs of MTN. The following factors were taken into consideration total turn around time, cost and potiential organs saved. Sending testing to a national laboratory extended the TAT by two - three fold. Cost increased 66% with inhouse testing when compared to the national laboratory. 24% of all potential organ cases are donation after circulatory death. In order for organ transplantation to occur, serology testing needs to be completed prior to proceeding to OR. Decreased TAT with in-house testing allows for increased recovery and placement of livers and lungs. In-house testing allows for a 12% increase in organ allocation. Based on the above findings, shipment of donor samples to a national testing laboratory was analyzed and determined not feasible. Optimization of organ allocation has a potential to save additional organs that were historically non-obtainable. Even though the cost of in-house infectious disease testing is higher than the national testing laboratory, the lives impacted by the OPO having total control over the donor screening process have proven to be invaluable.