Comparing demographics of organ donor referrals from the intensive care unit and outside units

Abstract

The Spanish organ donation system is a world leader in organ recovery. One of Spain's strategies is the identification of organ donor referrals outside of the intensive care unit (ICU) for intensive care to facilitate organ donation (ICOD). There are limited data comparing the profiles of ICU-based and non-ICU ICOD referrals. This single-center retrospective chart review analyzed organ donor referrals of ICU and non-ICU patients to better understand the demographic and clinical differences between cohorts. The primary outcome was to understand if organ donation conversion rates were similar between ICU and non-ICU referrals. We collected data from 745 organ donor referral candidates, 235 (32%) of whom entered ICOD protocols. Out of this cohort, 144 (61%) became actual organ donors, 37 of whom (26%) were referred from non-ICU units. The ICU had the highest organ donor conversion rate (66% of ICU ICOD patients became actual organ donors) whereas non-ICU referrals had a 51% conversion rate. Non-ICU unit donors contributed to 21% and 26% of all kidney and liver donations, respectively. Though organ referral candidates from non-ICU units contribute to a small proportion of actual donors, their donated organs are important to sustaining organ donation and transplant activity.

Comparative Study of the Impact of Human Leukocyte Antigens on Renal Transplant Survival in Andalusia and the United States

“…This has generated an impression of trust, transparency and altruism in society, which has made Spain the world leader in the number of organ donations per million inhabitants [26]. Other factors that have been identified as successful in Spain have been the broadening of the criteria for organ donation, the creation of protocols to promote organ donation after circulatory death, and the identification of potential organ donors outside the intensive care unit setting [27]. These divergent results in the two populations reveal that some regions have already reached a high degree of maturity in the full renal transplantation process, adjusting the action protocols to the social, cultural and health conditions of the territory.…”