Healthcare professionals, clinicials, and executives know that managing risk in systems with many interdependencies is complicated. A recent study entitled “The Impact and Implications of The COVID-19 Pandemic on Organ Procurement Outside of an Epicenter” in the journal Progress in Transplantation provides glimpse of the risks that COVID-19 surges may present to OPOs.
As the healthcare landscape continues to face significant resourcing pressures, the lessons learned can be applied to robust protocols and systems that will support transplant recipients in future COVID-19 waves, as well as in other events that may overwhelm hospitals.
The study notes that in the early phase of the pandemic, specified as from March 1 2020 until May 31 2020, hospitals continued to refer potential donors at the same levels. However, fewer organs were recovered, organ offers decreased, and donor yield dropped sharply.
Within this OPO, staff adapted relatively well by relying on previously established technical infrastructure, specifically remotely accessing hospital electronic medical records (EMR), a privilege not all OPOs have. Families were also approached on the phone. Additionally OPO staff tried to relieve some of the burden and strain within hospitals by moving donation after brainstem death donors to central donation facilities and free up beds.
The authors recommended future methods to further ensure continued performance, particularly in light of upcoming changes to CMS OPO certification and performance measures. Recommendations included:
- Staffing an OPO recovery surgeon to quickly recover and ship organs and add further flexibility in the event of shortages and resource constraints on the hospital side.
- Developing a central donation facility where donors could be transferred.
- Relocating potential transplant recipients to areas less affected by crisis and shortages
- Improvements in the allocation system to reduce non-productive offers that waste valuable time
- The capability to direct organ offers to active centers less impacted by the pandemic
Affo was designed to ensure that transplant centers, OPOs, and central allocation agencies can flexibly change rules quickly and with minimal disruption. It is also has the most targeted and efficient allocation recommendation engine in the transplant world, with support for electronic offers and automated back-up offers that consider a broader range of customizable exclusions, as well as more granular histocompatibility data for better matches and offers, sooner.