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©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Jun 24, 2016; 6(2): 423-428
Published online Jun 24, 2016. doi: 10.5500/wjt.v6.i2.423
Deceased donor organ procurement injuries in the United States
Tim E Taber, Nikole A Neidlinger, Muhammad A Mujtaba, Elling E Eidbo, Roxane L Cauwels, Elizabeth M Hannan, Jennifer R Miller, Anil S Paramesh
Tim E Taber, Indiana Donor Network, Indianapolis, IN 46202, United States
Nikole A Neidlinger, Donor Network West, San Francisco, CA 94583, United States
Muhammad A Mujtaba, Department of Nephrology, University of Texas Medical Branch, Galveston, TX 77550, United States
Elling E Eidbo, Roxane L Cauwels, Elizabeth M Hannan, Jennifer R Miller, Association of Organ Procurement Organizations, Vienna, VA 22182, United States
Anil S Paramesh, Tulane Transplant Institute, New Orleans, LA 70112, United States
Anil S Paramesh, Louisiana Organ Procurement Association, New Orleans, LA 70002, United States
Author contributions: Taber TE, Neidlinger NA and Paramesh AS contributed to the conception and design of the study; Taber TE and Mujtaba MA contributed to the acquisition and analysis of the data; all of the authors contributed to the drafting and critical revisions of the manuscript and gave final approval of the article to be published.
Institutional review board statement: As the study was done on deceased donors, no institutional review board approval was obtained (see body of manuscript).
Informed consent statement: As this was a study looking at deceased donor procurements, there are are no patients to consent as the subjects are legally dead per US law. Hence, we are asking for a waiver of informed consent requirements.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at Dryad repository, who will provide a permanent, citable and open-access home for the dataset. In addition, a copy of the signed statement should be provided to the BPG in PDF format.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Anil S Paramesh, MD, FACS, Tulane Transplant Institute, 1415 Tulane Ave, HC-5, New Orleans, LA 70112, United States.
anil.paramesh@hcahealthcare.com
Telephone: +1-504-9880783 Fax: +1-504-9887510
Received: January 30, 2016
Peer-review started: February 1, 2016
First decision: March 15, 2016
Revised: April 26, 2016
Accepted: May 17, 2016
Article in press: May 27, 2016
Published online: June 24, 2016
Processing time: 144 Days and 9.8 Hours
AIM: To determine the incidence of surgical injury during deceased donor organ procurements.
METHODS: Organ damage was classified into three tiers, from 1-3, with the latter rendering the organ non-transplantable. For 12 consecutive months starting in January of 2014, 36 of 58 organ procurement organization’s (OPO)’s prospectively submitted quality data regarding organ damage (as reported by the transplanting surgeon and confirmed by the OPO medical director) seen on the procured organ.
RESULTS: These 36 OPOs recovered 5401 of the nations’s 8504 deceased donors for calendar year 2014. A total of 19043 organs procured were prospectively analyzed. Of this total, 59 organs sustained damage making them non-transplantable (0 intestines; 4 pancreata; 5 lungs; 6 livers; 43 kidneys). The class 3 damage was spread over 22 (of 36) reporting OPO’s.
CONCLUSION: While damage to the procured organ is rare with organ loss being approximately 0.3% of procured organs, loss of potential transplantable organs does occur during procurement.
Core tip: This study represents a unique report looking into the incidence of surgical injuries during deceased donor organ procurement. There is no other large scale study reporting this. This represents a multi-organizational study, collecting data prospectively over a period of a year. This study will hopefully help define the problem and contribute to the development of basic standards that organ procurement organizations can follow across the country.
