Variation in donation after circulatory death hospital policies in a single donor service area - 20/06/22
, Rehma Shabbir b, Sneha Chebrolu c, Erin Vines d, Chad Trahan d, Patricia Niles d, Giuliano Testa aAbstract |
Background |
Historically, there has been wide variation among hospital policies for donation after circulatory death (DCD) processes. With more DCD donors as well as more organs from DCD donors being utilized, it is time to revisit the variability in DCD hospital policies.
Methods |
Collection of hospital characteristics, DCD referrals and completions, and DCD policies from the Southwest Transplant Alliance Donor Service Area. Content analysis of DCD hospital policies.
Results |
We found variability in referral requirements, discussion elements for authorization, pre-mortem interventions and process elements. Most policies allow prepping and draping (84.7% [83 of 98]) and premortem heparin administration (78.6% [77 or 98]). A minority allow femoral cannulation prior to extubation (19.4% [19 of 98]) or during the hands-off period (15.3% [15 of 98]).
Conclusions |
We recommend a national effort to achieve consistency and clarity in DCD hospital policies based on our findings of continued variability in DCD hospital policies.
Le texte complet de cet article est disponible en PDF.Highlights |
• | DCD organ donation is a low volume procedure at most hospitals. |
• | There is variability in DCD referral, workup and procedural elements within hospital policies examined in this study. |
• | OPOs should work with hospitals to reduce variability among DCD policies within their Donor Service Areas. |
• | National guidelines should be developed for best practices in DCD donation and DCD hospital policy. |
Keywords : Donation after circulatory death, Hospital policy, Authorization, Pre-mortem interventions, Organ donation
Plan
Vol 224 - N° 1PB
P. 595-601 - juillet 2022 Retour au numéro
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