Retrieving organs from brain-dead donors is logistically challenging and time consuming in hospitals. Multiple surgical teams often fly to a donor's hospital but frequently face delays in retrieving organs due to crowded operating-room schedules.
However, a new study shows that moving organ donors from hospitals to a regional stand-alone facility with a designated operating room for retrieving organs is more efficient and lowers costs considerably, according to new research by transplant surgeons at Washington University School of Medicine in St. Louis.
"The magnitude of these changes has been transformative, with no negative effects on the organ donation process," said the study's first author, M.B. Majella Doyle, MD, a Washington University liver transplant surgeon at Barnes-Jewish Hospital, who also directs the adult liver transplant program. "This approach of moving organ donors to a free-standing organ recovery center is one that we believe has great merit and could be implemented more broadly."
Historically, transplant teams have traveled to donors' hospitals, often at night, when operating rooms are more likely to be available, to perform time-sensitive surgeries. And typically they are assisted by local staff who are not always familiar with organ donation procedures.
To improve the organ donation process, Mid-America Transplant Services in 2001 built the nation's first stand-alone organ retrieval facility in St. Louis, a few miles from transplant centers at Washington University School of Medicine and Saint Louis University. The nonprofit organization coordinates organ donations and retrievals for eastern Missouri, southern Illinois and northeast Arkansas.
After patients are declared brain dead and families consent to organ donation, donors in areas covered by Mid-America Transplant are transported to the stand-alone facility either by ambulance, if the hospitals are within an 80-mile radius, or by air. The organization owns an airplane that can accommodate mechanical ventilators and other equipment needed to keep donors' bodies stable.
Surgical teams still must travel to the facility to retrieve donor organs, but they do not need to scramble for an open operating room. The operating room at the facility, which is primarily used by Washington University and Saint Louis University surgeons, can be scheduled as soon as a donor is available, so surgeons and patients' families all know what to expect.
"Organ donors often are given low priority in hospitals because of scheduled surgeries or emergency cases," explained the study's senior author, William C. Chapman, MD, the Eugene M. Bricker Chair of Surgery and surgical director of the Washington University transplant center at Barnes-Jewish Hospital. "In addition to the cost savings, we rarely encounter delays anymore, making organ donation easier on families who have lost loved ones and on transplant teams because we can know when donors' surgeries will take place."
The facility also is staffed by critical care nurses and other personnel who have expertise and training in organ donation.