Preparing Patients for Transplant & Maximizing Donor Acceptance

Transplant outcomes are improved if patients are strong going into the surgery. We have many projects focused on the right time for transplantation. Donor availability is an ACTION priority and can be improved by sharing experiences on donor acceptance and perfecting best donor recipient size match.

What is the project focus?

The number of children needing a heart transplant has risen over time with the associated waitlist mortality being unacceptably high.  Many potentially “acceptable” donor organs are either turned down by pediatric centers and are either allocated to an adult program or are not allocated at all. Despite increasing experience, donor acceptance criteria are not well established in pediatric heart transplantation. This project, named the Donor Decision Discussion Forum, is designed to study donor acceptance and decline practices across the pediatric centers in ACTION and Pediatric Heart Transplant Society (PHTS). This project also aims to develop educational and decision-making aids to allow providers to use best evidence or guidelines for accepting and declining donor heart offers. 

Who is impacted?

All heart failure and transplant providers in ACTION and/or PHTS that are accepting donor organs for recipients.

What are we doing to help?

ACTION holds a monthly provider/clinician discussion forum to discuss donor organ cases.  

What data do we have?

Our Donor Decision Discussion Forum data was presented at the International Society of Heart and Lung Transplantation (ISHLT) scientific meeting, April 2022.

Key Takeaways
  • Significant variation in pediatric donor acceptance practices.
  • Donor characteristics the most influential in decision-making.
  • Discussants changed decisions in almost 1/3rd of the participants suggesting that the forum has the impact to alter donor decision making practices.
  • Donor Decision Discussion Forum is a potential format to reduce practice variation, provide education to decision makers and eventually increase donor utilization.