DNA’s Donor Care Center 

OVERVIEW: 

Donor Network of Arizona’s (DNA) donor care center (DCC) is the first of its kind for Arizona’s organ donation program. The DCC, located at Banner University Medical Center Phoenix (BUMCP) provides dedicated ICU and OR space and staff for the management and recovery or organs from donors following neurological determination of death. The DCC offers a dedicated team focused on facilitating donation. This differs from the most recent model in which donation cases are managed at dozens of individual hospitals superimposing donor management and organ recovery needs on top of a busy ICU and OR service’s clinical routine.

The DCC accepts the transfer of brain dead donors as young as 16 years old from adult ICUs.  Patients who offer gifts through donation after circulatory death (DCD) will remain at the referring donor hospital for donor management, removal of ventilator and recovery.

BENEFITS OF THE DCC: 

DNA began a five-year strategic plan in 2022, which included exploration of a DCC as one of multiple strategies to improve our ability to carry out our mission of saving and healing lives through donation. Through the strategic planning process, it became clear that a DCC could more fully realize the generosity of donors and their families, expand the impact on lives saved through the vital gift of organ donation, and would increase effectiveness within the everchanging Arizona and national health care systems. 

Donor Family Support 

When a person authorizes donation, or a family authorizes donation on behalf of their loved one, DNA is entrusted to make the most of those gifts, saving as many lives as medically possible. The DCC is intended to improve that ability to honor DNA’s commitment to donors and their families.

After the transfer and throughout the donation process, donation and family advocates (DFAs) continue to care for donor families. In most cases, staying in touch by phone allows grieving families to care for one another in the comfort of their home. The DFAs also facilitate rituals for final farewells and help with memory making to celebrate the generosity of the donor as appropriate at the originating hospital before the donor is transferred to the DCC.

Afterward, all donor families are offered the opportunity to participate in DNA’s two-year aftercare program, which includes access to grief resources, invitations to events, opportunities to honor their loved ones as heroes, correspondence support with recipients, and much more.

Increasing Lives Saved

The DCC is one more step that DNA has taken to save as many lives as possible. This is DNA’s responsibility to patients awaiting transplants and part of its commitment to donors and their families. Having donor management and recovery take place in a fully controlled environment, with identified resources and support in place, increases the quality of clinical management and improves control of the timing of organ recovery. This results in more organs transplanted and more lives saved—broadening the impact of every donor.

Process Efficiency

This change addresses challenges that can be experienced as the time and process to carry out donation can cause a strain on existing donor hospital resources. This may include challenges related to a hospital’s size and location, 24/7 availability of resources including staffing, specialty testing and procedures, as well as OR space. The DCC has critical care space for four donors, dedicated donor nurse staffing, specialists, guaranteed OR space and workspaces exclusively for DNA.  

Benefits to the originating hospital (from where the donor is referred), in turn, will be available ICU bed space, staff and OR times that are no longer needed for some organ recovery cases.

DEFINITIONS: 

• Originating hospital – Referring donor hospital where the patient was admitted and subsequently died. 
• Transfer – Process of moving donor from originating hospital to DCC, not to be confused with transport from one hospital unit to another within the same facility. 

FREQUENTLY ASKED QUESTIONS: 

Which patients will be transported to the DCC? 

• Brain dead patients, 16 years or older, and in an adult ICU, will be considered for transfer to the DCC. 
• DNA will not transfer a patient deemed too unstable for transfer, rather DNA will work with the originating hospital to facilitate donation. If the patient becomes stable enough for transfer during donor care, DNA may explore transfer at that time. 

What would be the timeline of transfer of a brain dead donor?

• It is DNA’s responsibility to initiate the transfer to the DCC. After speaking with the family, and in collaboration with the originating hospital, DNA is responsible for initiating the transfer process.

What prompted this change?

• The inspiration for a constant effort to improve stems from DNA’s commitment to better serve and care for donors, their families and waiting list candidates who rely on our work.
• Similarly, DNA has long centralized tissue recovery at a few locations in Phoenix and Tucson and has seen sustained benefits.

When will this process be implemented at my hospital?

• DNA predicts complete implementation will extend patient transfer capabilities to donors at all hospitals in Arizona in the future.
• The projected date for this program to include all Metro Phoenix hospitals is Q4 of 2024. DNA will explore further statewide expansion in 2025. 

Will DNA open more than one DCC?

• DNA leadership currently has no plans to open a second DCC. They will continue exploring the idea of more than one DCC while monitoring the benefits and areas of opportunities of this first DCC.

Will the DCC transfer process expand to DCD donors, too?

• This process currently includes only brain dead donors, 16 years or older. Donation after circulatory death (DCD) cases are currently not part of this change in donation protocol.
• The decision to include DCD donors in the future hasn’t been made yet.

Have other OPOs made a similar change to establish hospital-based DCCs? 

• Multiple Organ Procurement Organizations (OPOs) have adopted this best practice working in collaboration with a hospital including:
  • ARORA – Arkansas OPO
  • LifeLink of Georgia – Georgia OPO
  • LifeSource – Minnesota, North Dakota and South Dakota OPO 
  • Gift of Hope Organ & Tissue Donor Network – Illinois OPO 
  • Tennessee Donor Services – Tennessee OPO 
  • Donor Network West – California OPO 
• The establishment of a DCC for an OPO is a recommendation from the National Academies of Sciences, Engineering, and Medicine (NASEM) committee as part of a longer list of suggestions the committee advised OPOs to execute within five years of its publishing. View NASEM’s fill report at Realizing the Promise of Equity in the Organ Transplantation System (2022). You may download the free PDF as a guest user. 

For further questions, please reach out to your hospital’s donation coordinator or email contact.us@dnaz.org.