Brain Death
Conditions
Keywords
Tissue Oxygen Saturation, Management of the DNC Organ Donor
Brief summary
The objective of this study is to quantify the association between tissue oxygen saturation (StO2) during the donor management phase of the Death by Neurological Criteria (DNC) organ donor and the number of organs transplanted per donor.
Detailed description
Specifically the study aims to: 1. Evaluate the association between StO2 level in the DNC organ donor and the number of organs transplanted per donor; 2. Evaluate whether or not tissue perfusion in the DNC organ donor population correlates with currently measured macro-hemodynamic variables during the donor management phase. 3. Assess if StO2 in the DNC organ donor is related to the number of organs with normal end-organ function, and with the number of organs predicted to be transplanted using the organ donor calculator. 4. Assess if StO2 in the DNC organ donor is related with intravenous thyroid hormone treatment. Investigators will conduct an observational study, including 60 DNC organ donors, in Lifebanc's Donor Service Area (DSA). Investigators will monitor and record blindly the StO2 with near-infrared spectroscopy (NIRS) in the DNC organ donor from the beginning of the OPO (Organ Procurement Organization) organ donor management period until cardiac arrest in the operating room at the time of recovery.
Interventions
None listed
Sponsors
The Cleveland Clinic
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
15 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. DNC organ donor 2. Age ≥ 15 years old 3. Weight ≥ 45 Kg
Exclusion criteria
1. Donor after circulatory determination of death 2. Living donor
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Number of organs transplanted per donor | At 24 hours after transfering the donor to operating room. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of organs with targeted end-organ function per donor | At the last hour at the Intensive Care Unit, before the donor is transferred to the operating room. | Normal end-organ function definitions 1. Kidney function: Creatinine ≤ 1.5 mg/dL, urinary output ≥ 0.5 ml/kg/h 2. Liver function: INR \<1.5, Prothrombin time: 8.4-13 seconds (or within normal range per testing lab). Bilirubin, AST, ALT within normal range per laboratory limits. 3. Lung function: PaO2/FiO2 index ≥ 300 with PEEP ≤ 8 (oxygen challenge gas) 4. Heart function: Normal systolic and diastolic function per echocardiogram with minimal inotropic/vasopressor support. Systolic function will be estimated by ejection fraction and/or shortening fraction on echocardiogram. Normal cardiac catheterization data if available 5. Pancreatic function: HbA1c\<6, amylase and lipase within normal range per laboratory limits. 6. Small intestine function: lactate ≤ 2.2 mmol/L with minimal vasopressor support. |
| Number of organs predicted to be transplanted using organ donor calculator | At the last hour at the Intensive Care Unit, before the donor is transferred to the operating room. | — |
| Correlation of tissue oxygenation readings to macro-hemodynamic measurements | During donor management until cardiac arrest at the operating room | Mean arterial pressure, central venous pressure, cardiac output, positive pressure variation, stroke volume variation |
| Variation of tissue oxygenation after thyroid hormone is initiated, titrated and/or discontinued. | During donor management until cardiac arrest at the operating room | — |
Countries
United States
Outcome results
None listed