Transplanted donor kidneys save lives, but availability does not meet demand. Contributing to the problem is that some people who are willing to be donors have organs that are considered unsuitable for transplant. A new procedure has been successful in making some of these previously rejected kidneys usable again.
The procedure involves flushing donated kidneys, which would previously have been rejected as unsuitable for transplant, with oxygenated blood (normothermic perfusion). This can allow use of some damaged kidneys, such as those from the elderly or those with high blood pressure or diabetes. It decreases the risk of a marginal organ being rejected. It is believed that this could increase the availability of organs by about 500 a year in the United Kingdom, reducing the number of people on transplant waiting lists by about 10%. (There are more than 6,400 kidney patients waiting for a transplant in the UK.)
So far, 17 organs that have been through the procedure have been successfully transplanted, between November 2010 and November 2011. They are all functioning well. The success of this procedure can be examined in a Cause Map, or visual root cause analysis. Positive impacts to the goals can be examined in the same way that negative impacts are – by identifying the impacts and asking “why” questions to identify the causes. Due to this procedure, the patient safety goal has been impacted by reducing the risk of rejected transplanted organs. The patient services and material goal has been impacted by increasing the availability of donor kidneys. And, the “labor” goal has been impacted by reducing the amount of time people wait for donor kidneys.
Beginning with these impacts and asking “why” questions, we can identify that the procedure is allowing the use of previously marginal organs by allowing treatment outside the recipient body and reducing the risk of rejection. This increases the number of organs that can be used, and since there are still more organs needed than available, this reduces the amount of time on the waiting list.
Although this procedure should increase the number of organs available and reduce time on the waiting list, it still will not provide enough organs for everyone who needs one. Donor outreach to increase donors and family understanding of the life-saving organ donation process is still needed.
To view the Outline and Cause Map, please click “Download PDF” above. Or click here to read more.