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Prog Transplant. 2015 Dec;25(4):351-60. doi: 10.7182/pit2015129.

Impact of a quality improvement project on deceased organ donor management.

Author information

1
University of California, San Francisco (AO, JF, RH, JPR, CUN), California Transplant Donor Network, Oakland, California (SS), Hospital Clinic, Barcelona, Spain (AB).

Abstract

CONTEXT:

Donors showed poor glucose control in the period between declaration of brain death and organ recovery. The level of hyperglycemia in the donors was associated with a decline in terminal renal function.

OBJECTIVE:

To determine whether implementation of a quality improvement project improved glucose control and preserved renal function in deceased organ donors.

METHODS:

Data collected retrospectively included demographics, medical history, mechanism of death, laboratory values, and data from the United Network for Organ Sharing.

RESULTS:

After implementation of the quality improvement project, deceased donors had significantly lower mean glucose concentrations (mean [SD], 162 [44] vs 212 [42] mg/dL; P<.001) and prerecovery glucose concentration (143 [66] vs 241 [69] mg/dL; P<.001). When the donor cohorts from before and after the quality improvement project were analyzed together, mean glucose concentration remained a significant predictor of terminal creatinine level (P<.001). Multivariate analysis of delayed graft function in kidney recipients matched to donors indicated that higher terminal creatinine level was associated with delayed graft function in recipients (P<.001).

CONCLUSION:

The quality improvement project improved donor glucose homeostasis, and the data confirm that poor glucose homeostasis is associated with worsening terminal renal function.

PMID:
26645930
PMCID:
PMC5314946
DOI:
10.7182/pit2015129
[Indexed for MEDLINE]
Free PMC Article

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