Centralized Organ Procurement Organization Surgical Center: First 200 Brain Dead Organ Donor Transfer Experience.

Abstract

Purpose: To evaluate the clinical and business case of utilizing a stand-alone Organ Procurement Organization (OPO) surgical center following 200 brain dead organ donor transfers and removal of organs for transplant. Methods: Operational, financial, logistical and donor family satisfaction metrics among 200 organ donors transferred to an OPO surgical center are contrasted with a population of organ donors performed at the hospital where brain death was declared. Results: Between 8/26/10 and 12/30/13, 200 patients were transferred from hospitals where brain death was declared to an OPO surgical center for standardized organ procurement within a large geographical donation service area. The following table reviews a range of operational and financial metrics associated with the organ donor transfer population:Table: No Caption available.The first 12 brain dead transfers in 2010 were limited to abdominal only donors, which account for a lower number of organs transplanted per donor (OTPD) in the first year in contrast to the 4.2 OTPD in 2013. The 2013 median procurement cost per donor was significantly lower (p<0.5) in the transfer population ($14,982) compared to brain dead cases facilitated at the donor hospital ($19,890), with the OPO not having to increase non-Medicare organ acquisition fees for the past four years. Clinical skill set development of OPO procurement coordinators allowed for the replacement of variable anesthesiology staffing in early 2013. This staffing change nearly doubled the percent and volume of donor transfer cases from the previous year. Mean donor family satisfaction scores are statistically equivalent for the brain dead donor transfer group (4.88; n=95), when compared to the aggregate mean scores among brain dead donor cases performed at the donor hospital (4.89; n=228). Conclusion: An OPO surgical center model demonstrates the ability to increase OTPD, reduce procurement costs and sustain donor family satisfaction as compared to the more common donor procurement model.