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Putting the Pieces Together: The National Donation and Transplantation Community of Practice. 2009: Bringing the Pieces Together. DSA Action Teams convened in January Regional Collaborative Leaders CEO Executive Summit Pediatric Executive Summit Donor Management Forum Local DSA Action

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putting the pieces together the national donation and transplantation community of practice

Putting the Pieces Together: The National Donation and Transplantation Community of Practice

2009 bringing the pieces together
2009: Bringing the Pieces Together
  • DSA Action Teams convened in January
  • Regional Collaborative Leaders
  • CEO Executive Summit
  • Pediatric Executive Summit
  • Donor Management Forum
  • Local DSA Action
  • Regional Forums, Conference Calls
  • State Hospital Association Partnerships
important pieces of the puzzle
Important Pieces of the Puzzle
  • Making the pieces fit
    • In your organization
    • In your DSA
    • In your Region
    • Among the 4 estates
    • With new DSA Partners
slide4

OPO and Donor Hospital

Three Estates

Potential Deceased Donor Population

Donor Management

Donation

Donor

Push

Potential Recipient Populations

Our National System

Offer & Acceptance

Organs

Patient

Transplant Centers

Pull

Wait List Management

Organs Transplanted

Center Capacity

our national goals
Our National Goals
  • 35,000 deceased donor organs transplanted
  • 75% conversion rate
  • 3.75 organs transplanted per donor (OTPD)
  • 10% DCD in all 58 DSAs
steady increases in monthly organs transplanted
Steady Increases in Monthly Organs Transplanted

September 2003: 1800 organs

May 2009: 2100 organs

Target: 2900 organs

waiting list deaths 1999 20083
Waiting List Deaths1999-2008

1999 - 2003

2004 -2008

Total Deaths

34,380

34,236

Deaths/Year

6,876

7,047

Deaths/Day

19

19

conversion rate goal
Conversion Rate Goal
  • National Goal:
    • 75% Collaborative Conversion Rate
      • (All Donors) / (Eligible) * 100
types of donors
Types of Donors
  • SCD: Standard Criteria Donors - an individual whose organs are donated after his or her death
  • DCD: Donation after Cardiac Death - donors whose hearts have irreversibly stopped beating
  • ECD: Expanded Criteria Donors - deceased donor over the age of 60 years; or from a donor over the age of 50 years with two of the following: a history of hypertension, a terminal serum creatinine greater than or equal to 1.5 mg/dl, or death resulting from a cerebral vascular accident (stroke)
monthly conversion rate nearing 75 goal
Monthly Conversion Rate Nearing 75% Goal

22 of 58 DSAs at 75% for a continuous 12-month period

dsas mobilizing for otpd breakthrough
DSAs Mobilizing for OTPD Breakthrough

Only one DSA has achieved 3.75 for 12 continuous months

SCD OTPD 2008: 3.80

SCD OTPD 2009: 4.56

sustained increases in dcd
Sustained Increases in DCD

28 of 58 DSAs meet the 10% Goal

9 additional DSAs at 7-9%

sustained increases in dcd1
Sustained Increases in DCD

>4700 organs tx

In 2004-2008

28 of 58 DSAs meet the 10% Goal

9 additional DSAs at 7-9%

our progress in the largest hospitals
Our Progress in the Largest Hospitals
  • 400 Hospitals
  • 8+ Hospitals: 8 or more eligible deaths
  • Sub-groups:
    • Top 50 Hospitals: 29-92 eligible deaths
    • Remaining Hospitals: 8-28 eligible deaths
take away messages
Take Away Messages
  • Increase heart and kidney availability
  • Monthly conversion rate nearing 75% - but don’t lose sight of imminent deaths and non-declared patients
  • 37 DSAs meet or close to DCD goal - transparency for DCD vs DBD is essential
  • OTPD unchanged but progress in some DSAs
  • Review donation systems in large hospitals
  • Renew focus in all 8+ hospitals
  • Help transplant programs meet 20% goal