Efficiency of the Tissue Procurement Process: What Evaluation Tools?

• Published in: Transplantation proceedings 2010-07, Vol.42 (6), p.2195-2196
• Main Authors: Saviozzi, A, Bozzi, G, De Simone, P, Filipponi, F
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Cohort Studies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Hospital Mortality - trends; Humans; Italy; Medical sciences; Patient Selection; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue and Organ Procurement - standards; Tissue Donors - statistics & numerical data; Tissue, organ and graft immunology
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2010.05.024

Abstract Evaluation of the efficiency of tissue procurement (TP) requires appropriate indicators. We report the results of a survey on all in-hospital deaths in Tuscany performed to identify potential indicators of efficiency with regard to donor identification and evaluation. In January 2004, we established a regional, compulsory, prospective program to monitor all in-hospital deaths in Tuscany. Currently, in Tuscany TP is performed if donors are ≤75 years without evidence of infectious or malignant diseases. Between January 2004 and December 2008, we analyzed data on 75,921 in-hospital deaths, including 50,001 (66.9%) in subjects older than 75 years, while 25,920 (33.1%) were ≤75 years and thus considered for TP. Among the latter cohort, 11,657 (15.3%) presented with clinical contraindication(s), while 14,263 (18.8%) were fit for tissue donation. Of the latter population, tissue donation occurred in 3083 cases (ie, 4% of in-hospital deaths or 11.8% of potential tissue donors). Contraindications to tissue donation were identified in 9861 cases (12.9%) based on clinical files, and in 1796 (2.4%) after interview with the family. There was a great variability by regional hospital in the percent of contraindications identified after the family interview, from a low of 4% to a high of 45%. Based on our experience, implementation of efficiency parameters and improvement of the efficiency of the entire TP process requires compulsory reporting of in-hospital deaths by local transplant coordinators.