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Donor Heart Management Project


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DAVID P NELSON, MD
ISHLT HFTM Council Communications Liaison
Chief, Heart Transplant Medicine Division
INTEGRIS Nazih Zuhdi Transplant Institute
Oklahoma City, Oklahoma, USA

david.nelson@integris-health.com


The Donor Management Task Force (DMTF) is interested in the increasing VAD volume in the United States and the increased visibility of heart failure cardiologists managing these patients in ICUs. The DMTF decided to explore the possibility of more formal and structured involvement of heart failure cardiologists in donor management. A pilot project in Oklahoma is developing this concept.

Preliminary goals of the project are to:

  1. Provide advanced instruction in donor management to heart failure cardiologists at the transplant/VAD center: INTEGRIS Baptist Medical Center.
  2. Provide advanced instruction in donor management to intensivists at the transplant center and the state's three highest-volume donor centers.
  3. Develop a strategy for partnering intensivists and cardiologists with OPO staff in donor management that:
    •  Is conducive to an integrated team approach;
    •  Realistically accommodates the "day jobs" of the non-OPO physicians;
    •  Respects the prerogatives of out-of-state importing transplant programs.
  4. Identify metrics with historical controls to determine what got better or worse as a result of the project.
  5. Identify potential prognosticators for the unused but salvageable heart.
  6. Identify future research objectives as the project evolves.

Resource materials for the cardiologists were provided by nationally recognized donor management expert Dr. Darren Malinoski. Two other donor management experts, Drs. Nancy Knudsen and Michael Moncure, will be speaking to project physicians about general donor and donor cardiac management early next year. Dr. Knudsen is an anesthesia intensivist from Duke. Dr. Moncure is part of a critical care "task force" which for years has provided critical care services for one of the country's best OPOs in Kansas.

The heart failure/VAD cardiologists participating in this project are Doug Horstmanshof and Patrick Fisher (ISHLT members), and Angie Brittsan.



Disclosure Statement: The author has no conflicts of interest to disclose.