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

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.

• Authors: Andrea Olmos, John Feiner, Ryutaro Hirose, Sharon Swain, Annabel Blasi, John P Roberts, Claus U Niemann
• Journal: Progress in transplantation (Aliso Viejo, Calif.) (Prog Transplant) Vol. 25 Issue 4 Pg. 351-60 (Dec 2015) ISSN: 1526-9248 [Print] United States
• PMID: 26645930 (Publication Type: Comparative Study, Journal Article, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Blood Glucose

Topics

• Adult
• Blood Glucose (metabolism)
• Brain Death (physiopathology)
• Cadaver
• Cohort Studies
• Female
• Glomerular Filtration Rate
• Homeostasis (physiology)
• Humans
• Kidney Transplantation (methods)
• Male
• Middle Aged
• Quality Improvement
• Retrospective Studies
• Tissue Donors
• Tissue and Organ Procurement (methods)
• Transplants (physiology)