1. A 360° Rotational Positioning Protocol of Organ Donors May Increase Lungs Available for Transplantation
- Author
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Harry E. Wilkins, Jody C. Olson, Lori Markham, Dustin Neel, Melissa Ott, Michael Moncure, Donald G. Vasquez, Scott S. Johnson, Stevan P. Whitt, Marissa A Mendez, Alyssa J. Fesmire, and Harbaksh Sangha
- Subjects
Organ procurement organization ,Adult ,Male ,medicine.medical_specialty ,Brain Death ,Tissue and Organ Procurement ,medicine.medical_treatment ,Critical Care and Intensive Care Medicine ,Donor Selection ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Lung transplantation ,Humans ,Donor management ,Lung ,Lung function ,Retrospective Studies ,business.industry ,030208 emergency & critical care medicine ,Retrospective cohort study ,respiratory system ,Middle Aged ,Tissue Donors ,respiratory tract diseases ,Surgery ,Transplantation ,Organ procurement ,medicine.anatomical_structure ,030228 respiratory system ,Tissue and Organ Harvesting ,Female ,business ,circulatory and respiratory physiology ,Lung Transplantation - Abstract
OBJECTIVES To evaluate the improvement in lung donation and immediate lung function after the implementation of a 360° rotational positioning protocol within an organ procurement organization in the Midwest. DESIGN Retrospective observational study. SETTING The Midwest Transplant Network from 2005 to 2017. Rotational positioning of donors began in 2008. SUBJECTS Potential deceased lung donors. INTERVENTIONS A 360° rotational protocol. Presence of immediate lung function in recipients, change in PaO2:FIO2 ratio during donor management, initial and final PaO2:FIO2 ratio, and proportion of lungs donated were measured. Outcomes were compared between rotated and nonrotated donors. MEASUREMENTS AND MAIN RESULTS A total of 693 donors were analyzed. The proportion of lung donations increased by 10%. The difference between initial PaO2:FIO2 ratio and final PaO2:FIO2 ratio was significantly different between rotated and nonrotated donors (36 ± 116 vs 104 ± 148; p < 0.001). Lungs transplanted from rotated donors had better immediate function than those from nonrotated donors (99.5% vs 68%; p < 0.001). CONCLUSIONS There was a statistically significant increase in lung donations after implementing rotational positioning of deceased donors. Rotational positioning significantly increased the average difference in PaO2:FIO2 ratios. There was also superior lung function in the rotated group. The authors recommend that organ procurement organizations consider adopting a rotational positioning protocol for donors to increase the lungs available for transplantation.
- Published
- 2019