Gauthier Jason M, Terada Yuriko, Takahashi Tsuyoshi, Nava Ruben G, Kreisel Daniel, Meyers Bryan F, Kozower Benjamin D, Patterson G Alexander, Brandt Whitney S, Marklin Gary F, Witt Chad A, Byers Derek E, Vazquez Guillamet Rodrigo, Hachem Ramsey R, Puri Varun
Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, Missouri.
Mid-America Transplant, St Louis, Missouri.
Ann Thorac Surg Short Rep. 2024 Apr 2;2(3):563-566. doi: 10.1016/j.atssr.2024.03.006. eCollection 2024 Sep.
Organ procurement organizations coordinate organ donation through 2 distinct models of care: the conventional model, in which donors are managed at hospitals where brain death occurs, and the specialized donor care facility (SDCF) model, where brain dead donors are transferred to a freestanding facility. The aim of this study is to compare operating room efficiency for procurements between the SDCF and conventional models of care.
We performed a prospective analysis of operating room efficiency between thoracic donor procurement operations performed at a SDCF and other organ procurement organizations using the conventional model of care. Key domains of efficiency were chosen based on a literature review and expert panel consensus. Data were collected in real time over a 12-month period via direct observation and personnel interviews.
Between January 1 and December 31, 2018, data were obtained from 54 procurement operations (n = 17 SDCF; n = 37 conventional). Donors in the 2 groups were similar in baseline characteristics. Procurements at the SDCF were performed with fewer nonsurgeon team members (2 vs 4, < .001) without any difference in the organ yield. SDCF procurements more closely adhered to planned start times (6 vs 61 minute difference, < .001), and a trend was observed for SDCF-based procurements to facilitate daytime transplant operations.
The SDCF model of donor care outperforms the conventional model in several important measures of operating room efficiency. These differences are likely to result in cost savings and improved healthcare provider satisfaction in the highly effort- and resource-intensive landscape of organ transplantation.
器官获取组织通过两种不同的护理模式协调器官捐赠：传统模式，即在发生脑死亡的医院管理捐赠者；以及专门的捐赠者护理设施（SDCF）模式，即将脑死亡捐赠者转移到独立的设施。本研究的目的是比较SDCF模式和传统护理模式下器官获取的手术室效率。
我们对在SDCF进行的胸段捐赠者获取手术与使用传统护理模式的其他器官获取组织之间的手术室效率进行了前瞻性分析。基于文献综述和专家小组共识选择了关键的效率领域。通过直接观察和人员访谈在12个月期间实时收集数据。
在2018年1月1日至12月31日期间，从54例获取手术中获得数据（n = 17例SDCF；n = 37例传统模式）。两组捐赠者的基线特征相似。SDCF的获取手术中，非外科团队成员较少（2名对4名，<0.001），器官产量无差异。SDCF的获取手术更严格地遵守计划开始时间（相差6分钟对61分钟，<0.001），并且观察到基于SDCF的获取手术有促进日间移植手术的趋势。
在手术室效率的几个重要指标方面，SDCF捐赠者护理模式优于传统模式。在器官移植这种高度耗费精力和资源的领域，这些差异可能会带来成本节约并提高医疗服务提供者的满意度。
