Neurologically Deceased Patients and the Role of Critical Care Transport

Currently, over 107,000 people are waiting for organs on the US transplant list, and by the end of 2024 over 38,000 are projected to be transplanted. Unfortunately, 17 people die each day in the United States awaiting organ transplantation. Increasingly, evidence has shown that optimal medical management of the donor is essential, maximizing the function of transplanted organs, the number of recoverable organs, and the quality of life conveyed for the recipients. Historically, in the majority of organ donation programs throughout the US, donor organs are procured at the facility in which the deceased has been cared for. There is increasing support for procuring organs, from those donors who have died from brain death, in a centralized tertiary facility who specifically specialize in optimizing the quantity and long-term function of transplanted organs. Conversely, the resources for specific organ donation testing may not be as readilly available at community medical center. This, has led to the Critical Care Transport of brain dead donor patients to specific donation centers where appropriate testing and procurement can take place. Safely transporting and managing those patients who have progressed to brain death, and who’s family has consented for donation to such facilities directly falls under the scope of practice for Critical Care Transport. Although the clinical, as well as logistical management of patients with brain death may be challenging as these patients are often unstable, it is precisely the skill set of critical care transport providers.

In this presentation, we will discuss the rationale for involvement of Critical Care Transport teams in the care of donor patients. We will review the unique clinical and logistical challenges to compassionately care for these patients while preserving success of organ donation. Finally, we will engage in a dialogue regarding our organization’s experience within the process.