1. OneLegacy Status 1A cases
Aaron Cohen
Manager of Donor Allocation
OneLegacy

2. Case 1 Demographics Medical History:
5’10”, 193 lbs.
COD:
MVA, driver struck the back of another vehicle.
Medical History:
Consumed 24 pack of beer every weekend last 10 years per family

3. Lab Panel

4. ABG’s

5. Donor Work up
Moderate bilateral perihilar and basilar lung consolidation noted, right greater than left, consistent with bilateral pneumonia or adult respiratory distress syndrome, or pulmonary contusion. The degree of lung consolidation appears worse in comparison to earlier examination.
CXR

6. Other factors
Family gave no time constraints and was eager to donate all organs
24 hours case time elapsed
Family
Trauma center
Difficult to schedule and keep a solid OR time at this facility
Hospital
One of 5 active donors being managed that day
Difficult to maintain coverage for all the cases
Staffing

7. Urgent Request PTR made anahepatic due to transplant 10 days ago PNF
Local Liver Center Urgent Request
Clinical, Allocation and Administrative management huddled and identified this case as possibility to rush
Internal conference call
Lungs – No offers made yet, deemed unlikely for transplant due to contusions.
Heart – No offers made yet. Administrative decision to rush case to OR in order to recover liver for Urgent Status 1A
Cessation of Allocation efforts

8. Outcome Kidney Pancreas Intestine Heart Lung Liver
Not Recovered due to rushed case
Lung
Liver
Recovered and transplanted into Status 1A
Kidney
Both recovered and transplanted
Pancreas
Evaluated in OR and declined
Intestine
Declined nationally

9. Liver outcome PTR Status - Dead
Liver was transplanted successfully, but PTR died days later due to complications.
PTR Status - Dead

10. Case 2 Demographics Medical History: 1 month post partum
39/F
5’2”, 161 lbs.
COD:
SAH s/p admit to hospital for headache nausea, vomiting
Medical History:
1 month post partum
Severe headaches x3 weekly last 5 years
DVT in right leg 2-3 year ago

11. Lab Panel

12. ABG’s

13. Other factors Family was eager to get the process over with
48 houts case time elapsed
Family
Regional hospital
OR setting can be difficult as they are not willing to call in a surgical team on off hours very often
Hospital
One of 3 active donors being managed that day
Adequate staffing to manage all donors
Staffing

14. Urgent Request PTR made anahepatic due to previous transplant PNF
Local Liver Center Urgent Request
Clinical, Allocation and Administrative management huddled and identified this case as possibility to rush
Internal conference call
Lungs – Offers in progress.
Heart – Already placed at the time of Urgent Request
Allocation

15. Outcome Kidney Pancreas Intestine Both recovered and transplanted
Heart
Recovered and Transplanted
Lung
Bilateral Lungs recovered and Transplanted
One Lung PTR was bypassed due to need for Crossmatches, next local center accepted 4 hour prior to scheduled OR
Liver
Recovered and transplanted into Status 1A
Kidney
Both recovered and transplanted
Pancreas
Evaluated in OR and declined
Intestine
Declined nationally

16. Liver outcome PTR Status - Alive
Liver was transplanted the PTR is currently alive and thriving.
Liver and Left Kidney transplanted.
PTR Status - Alive

17. Questions