Accepted Manuscript Trends in Organ Donor Management: 2002-2012 Devon S. Callahan , MD Dennis Kim , MD Scott Bricker , MD Angela Neville , MD, FACS Brant Putnam , MD, FACS Jennifer Smith , MD Frederic Bongard , MD, FACS David Plurad , MD, FACS PII:
S1072-7515(14)00438-4
DOI:
10.1016/j.jamcollsurg.2014.04.017
Reference:
ACS 7425
To appear in:
Journal of the American College of Surgeons
Received Date: 9 February 2014 Revised Date:
8 April 2014
Accepted Date: 8 April 2014
Please cite this article as: Callahan DS, Kim D, Bricker S, Neville A, Putnam B, Smith J, Bongard F, Plurad D, Trends in Organ Donor Management: 2002-2012, Journal of the American College of Surgeons (2014), doi: 10.1016/j.jamcollsurg.2014.04.017. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
Trends in Organ Donor Management: 2002-2012
Devon S Callahan, MD, Dennis Kim, MD, Scott Bricker, MD, Angela Neville, MD, FACS,
RI PT
Brant Putnam, MD, FACS, Jennifer Smith, MD, Frederic Bongard, MD, FACS, David Plurad, MD, FACS
SC
Harbor-UCLA Medical Center, Division of Trauma, Surgical Critical Care and Acute Care
M AN U
Surgery, Los Angeles, CA.
Disclosure Information: Nothing to disclose.
Support: This work was supported in part by Health Resources and Services Administration contract 234-2005-37011C. The content is the responsibility of the authors alone and does not
TE D
necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the
EP
U.S. Government.
“Quick Shot” presentation at the 2013 meeting of the Southwestern Surgical Congress, Santa
AC C
Barbara, CA, March 2013.
Running head: Trends in Organ Donor Management Correspondence address: David Plurad, MD Harbor-UCLA Medical Center Trauma/ Surgical Critical Care 1000 W. Carson St., Box 42 Los Angeles, CA 90502 1
ACCEPTED MANUSCRIPT
Background: Refinements in donor management have resulted in increased numbers and quality of grafts after neurologic death. We hypothesize that the increased use of Hormone Replacement Therapy (HRT) has been accompanied by improved outcomes over time.
RI PT
Study Design: Utilizing the OPTN donor database; all brain dead donors procured from July 1st, 2001 and June 30th, 2012 were studied. HRT was identified by an infusion of thyroid hormone. An expanded criteria (EC) donor was defined as age ≥ 60 years. The incidence of HRT
SC
administration and the number of donors and organs recovered was calculated. Using the OPTN thoracic recipient database transplant list wait times were examined.
M AN U
Results: There were 74,180 brain dead donors studied. HRT use increased significantly from 25.6% to 72.3% of donors. However, the mean OPD remained static (3.51 to 3.50, p=0.083), and the rate of high yield donors decreased (46.4% to 43.1%, p < 0.001). The incidence of TBI donors (42.1% to 33.9%, p < 0.001) decreased relative to an increased number of (EC) donors
TE D
(22.1% to 26%). Despite this, there has been an increase in the raw number of donors (20,558 to 24,308, p
S1072-7515(14)00438-4
DOI:
10.1016/j.jamcollsurg.2014.04.017
Reference:
ACS 7425
To appear in:
Journal of the American College of Surgeons
Received Date: 9 February 2014 Revised Date:
8 April 2014
Accepted Date: 8 April 2014
Please cite this article as: Callahan DS, Kim D, Bricker S, Neville A, Putnam B, Smith J, Bongard F, Plurad D, Trends in Organ Donor Management: 2002-2012, Journal of the American College of Surgeons (2014), doi: 10.1016/j.jamcollsurg.2014.04.017. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT
Trends in Organ Donor Management: 2002-2012
Devon S Callahan, MD, Dennis Kim, MD, Scott Bricker, MD, Angela Neville, MD, FACS,
RI PT
Brant Putnam, MD, FACS, Jennifer Smith, MD, Frederic Bongard, MD, FACS, David Plurad, MD, FACS
SC
Harbor-UCLA Medical Center, Division of Trauma, Surgical Critical Care and Acute Care
M AN U
Surgery, Los Angeles, CA.
Disclosure Information: Nothing to disclose.
Support: This work was supported in part by Health Resources and Services Administration contract 234-2005-37011C. The content is the responsibility of the authors alone and does not
TE D
necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the
EP
U.S. Government.
“Quick Shot” presentation at the 2013 meeting of the Southwestern Surgical Congress, Santa
AC C
Barbara, CA, March 2013.
Running head: Trends in Organ Donor Management Correspondence address: David Plurad, MD Harbor-UCLA Medical Center Trauma/ Surgical Critical Care 1000 W. Carson St., Box 42 Los Angeles, CA 90502 1
ACCEPTED MANUSCRIPT
Background: Refinements in donor management have resulted in increased numbers and quality of grafts after neurologic death. We hypothesize that the increased use of Hormone Replacement Therapy (HRT) has been accompanied by improved outcomes over time.
RI PT
Study Design: Utilizing the OPTN donor database; all brain dead donors procured from July 1st, 2001 and June 30th, 2012 were studied. HRT was identified by an infusion of thyroid hormone. An expanded criteria (EC) donor was defined as age ≥ 60 years. The incidence of HRT
SC
administration and the number of donors and organs recovered was calculated. Using the OPTN thoracic recipient database transplant list wait times were examined.
M AN U
Results: There were 74,180 brain dead donors studied. HRT use increased significantly from 25.6% to 72.3% of donors. However, the mean OPD remained static (3.51 to 3.50, p=0.083), and the rate of high yield donors decreased (46.4% to 43.1%, p < 0.001). The incidence of TBI donors (42.1% to 33.9%, p < 0.001) decreased relative to an increased number of (EC) donors
TE D
(22.1% to 26%). Despite this, there has been an increase in the raw number of donors (20,558 to 24,308, p
