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An important message from the MPSC on donation after circulatory death (DCD) protocols and managing multiple organs

Published on: Wednesday, January 25, 2023

For the benefit of the donation and transplant community, the OPTN Board has authorized the OPTN Membership and Professional Standards Committee (MPSC) to disseminate learnings and effective practices observed during MPSC meetings and interactions with OPTN members. Updates will be provided by the MPSC after each of their in-person meetings.

The Organ Procurement and Transplantation Network (OPTN) Membership and Professional Standards Committee (MPSC) recently communicated to a large segment of OPTN members about several recommendations and opportunities for improvement in processes and protocols related to organ recovery and transplant.

The MPSC is an operating committee of the OPTN Board of Directors. In addition to monitoring for compliance with OPTN Final Rule, policies, and bylaws, the committee supports members through peer review and sharing of effective practices. Learn more about the MPSC.

Ensure DCD protocols are up to date and processes are communicated

In light of the changing landscape in DCD transplantation, the MPSC has been made aware of an increase in communication issues regarding the DCD process. The use of new techniques and technologies, including normothermic regional perfusion (NRP) and other perfusion devices, require increased communication and coordination between OPOs, donor hospitals, and transplant hospitals.  

Several recommendations have come out of recent MPSC discussions:

  • OPOs should ensure that their donor hospitals protocols and practices reflect current donation practices to include new technologies and procedures.
  • Early communication is key in ensuring all parties involved are aware of roles, responsibilities, and clear expectations throughout the process.
  • Transplant programs should communicate organ recovery plans to ensure all organ recovery teams and the OPO are informed and on the same page regarding expectations.

OPTN Policy 2.15.B states that OPOs and donor hospitals must establish protocols that define the roles and responsibilities for the evaluation and management of potential DCD donors, organ recovery, and organ placement in compliance with OPTN Policy.

DCD protocols should continue to be developed through collaboration between OPOs, transplants hospitals, and donor hospitals.

Be vigilant when managing multiple organs

We have seen misses and near misses that involve switched pump lids or paperwork when managing multiple organs. Near misses can happen anywhere, at all types of institutions, including those with robust quality systems in place. These incidents can potentially lead to a wrong organ being transplanted. We must always be guided by patient safety, and work together to maintain the integrity of the OPTN.

For questions or comments regarding this communication, please email MQFeedback@unos.org.