Organ donor facility is less costly, more efficient: An "ethical must"
Center allows maximum number of organs to be used
Moving organ donors from hospitals to a free-standing organ recovery center resulted in increased efficiency and lower costs, according to a recent study.1
The study analyzed 915 liver transplants performed at the center from 2001 to 2011, and found that travel time was reduced from 8 to 2.7 hours, with surgeon fly-outs reduced by 93%.
The Center was established in 2001 by Mid-America Transplant Services, which coordinates organ donations and retrievals for eastern Missouri, southern Illinois, and northeast Arkansas. "It was quite accidental, the way we figured it out," says Maria B. Majella Doyle, MD, MBA, FACS, the study's lead author. Doyle is associate professor of surgery at Washington University School of Medicine and director of the adult liver transplant program at Barnes-Jewish Hospital, both in St. Louis, MO.
When a community hospital was unable to perform a donor operation in 2001, the donor was moved to Barnes-Jewish Hospital so the procedure could be performed. "Once we did that, the organ procurement organization leadership said, maybe we should consider moving it out of the hospital altogether," says Doyle. Several states now have similar centers in place, "but politics often get in the way of making it happen," she explains.
Donors are given low priority in the hospital setting, at times, because of scheduled surgeries or emergency cases. If there is one surgical team and a trauma case comes in, for instance, that takes priority over the donor operation.
"Flying or driving the donor to the facility allows the investigation process to be performed efficiently and quickly, with no waiting," says Doyle.
"Huge comfort" to families
The Center holds a candlelight donor memorial service every year, attended by both recipient and donor families. Doyle frequently overhears comments from donor families such as "My brother saved five people."
"The donor families know how many organs were donated and how many were used," she says. "I feel very strongly that having the facility allows the staff to work with the donors to really maximize utilization. It's an ethical 'must,' if you will."
The maximum number of organs is utilized from every donor. The team is afforded the time to allow the heart to recover from whatever trauma the donor recipient had, for example, and to work with medical treatments to maximize the chances that lungs can be utilized.
"Donation is a huge comfort to a family," says Doyle. "They feel that their loved one is lost, but they are saving someone else's life."
Urgent need for education
There is an urgent need to educate the general public about organ donation and how important it is, emphasizes Doyle. "It's amazing how people still fear that somebody is not brain dead, even though they are brain dead. That's where the education has to come in," she says.
Tours are routinely given to groups of school-aged children, with the goal of teaching them about organ donation. "We talk about recipients and transplants and how people are able to live because of this," says Doyle. "The hope is that they will go home and talk to their families about organ donation."
The center's staff are trained to counsel families about donation. "These are the people who go to the families initially once we get word from the hospital that a donor is available," says Doyle. "They sit with them, they pray with them, they cry with them."
Families who initially refuse to donate often change their minds. Donor families are surveyed about their experience with the process.
"We have a hugely high satisfaction rate from families who have gone through the donation process," says Doyle. "They end up being so grateful for the process."
- Doyle MBM, Vachharajani N, Wellen, JR, et al. A novel organ donor facility: A decade of experience with liver donors. American Journal of Transplantation 2014;14(3):615620.
- Maria B. Majella Doyle, MD, MBA, FACS, Associate Professor of Surgery, Director, Liver Transplant, Washington University School of Medicine, St. Louis, MO. Phone: (314) 362-2880. E-mail: firstname.lastname@example.org.