Organ Donor Tissue Oxygen Saturation as a Predictor of Number of Organs to Transplant Per Donor
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||Tissue Oxygen Saturation During Management of the Deceased by Neurological Criteria Organ Donor as a Predictor of Number of Organs to Transplant Per Donor|
- Number of organs transplanted per donor [ Time Frame: At 24 hours after transfering the donor to operating room. ]
- Number of organs with targeted end-organ function per donor [ Time Frame: At the last hour at the Intensive Care Unit, before the donor is transferred to the operating room. ]
Normal end-organ function definitions
- Kidney function: Creatinine ≤ 1.5 mg/dL, urinary output ≥ 0.5 ml/kg/h
- 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.
- Lung function: PaO2/FiO2 index ≥ 300 with PEEP ≤ 8 (oxygen challenge gas)
- 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
- Pancreatic function: HbA1c<6, amylase and lipase within normal range per laboratory limits.
- Small intestine function: lactate ≤ 2.2 mmol/L with minimal vasopressor support.
- Number of organs predicted to be transplanted using organ donor calculator [ Time Frame: 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 [ Time Frame: 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. [ Time Frame: During donor management until cardiac arrest at the operating room ]
|Study Start Date:||April 2013|
|Study Completion Date:||March 2014|
|Primary Completion Date:||March 2014 (Final data collection date for primary outcome measure)|
Specifically the study aims to:
- Evaluate the association between StO2 level in the DNC organ donor and the number of organs transplanted per donor;
- Evaluate whether or not tissue perfusion in the DNC organ donor population correlates with currently measured macro-hemodynamic variables during the donor management phase.
- 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.
- 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.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01819116
|United States, Ohio|
|Cleveland, Ohio, United States, 44195|
|Principal Investigator:||Silvia Perez-Protto, MD||The Cleveland Clinic|
|Study Director:||Daniel Lebovitz, MD||Akron Children Hospital - Lifebanc|
|Study Director:||J. Steven Hata, MD||The Cleveland Clinic|