Bootcongres

Background: Waiting lists for organs continue to grow, and there is an increased need of transplantable organs. Surgical problems at procurement level can complicate the transplantation or can even cause loss of organs. In The Netherlands, all organs have to be evaluated by completing Quality Forms (QF) at transplantation- and procurement level. These forms are filled out for abdominal organs only, ie; liver, pancreas and kidney. The transplantation surgeon can place remarks on the form filled in by the procurement surgeon. This research gives an first impression of the quality of organ procurement in The Netherlands. transplants. Methods: The procurement and transplantation quality forms from March 2012 till august 2013 were analyzed. The forms were categorized by using a scoring system based on five categories. A (no remarks at procurement or transplantation level), B (a deviation remarked by the transplantation surgeon), C (a possibly avoidable damage of the organ) defined as a C1 score (damaged but transplantable) or a C2 score (damaged and discarded). A D score (an unavoidable damage of the organ) also subdivided in a D1 (damaged but transplantable) and a D2 (damaged and not transplantable). And an E score for all other remarks. Results: 420 of 563 (74,6%) sets of kidney QFs and 133 of 158 (84,2%) sets of liver QF’s were completed and analyzed. On average in 24,3% (14,5%– 60%) of the kidneys and in 27,8% (21.6% -40%) of the livers a possibly avoidable damage of the organ was found. 1.4 % of the kidneys was discarded caused by a possibly avoidable injury. For the liver less than 1% was discarded partly caused by a possibly avoidable injury. In 22,1% a deviation between the transplant and procurement was found in the analyzed kidney forms and 21.8% of the liver forms. This means that the transplanting surgeon noted damage to the organ that was not seen or differently assessed by the procuring surgeon Conclusion: This research shows the percentages of ‘possibly avoidable damage’ during organ procurement, and although these seem rather high, these are comparable to the (few) literature about this subject. There was a trend between procurement center volume and organ damage; the higher the number of procurements per center, the lower the percentage of possibly avoidable damages. Feedback on this research to the centers will hopefully lead to further improve quality of procurements.