T. Orouji Jokar1, B. Joseph1, M. Khalil1, N. Kulvatunyou1, B. Zangbar1, A. Tang1, T. O’Keeffe1, L. Gries1, R. Latifi1, R. S. Friese1, P. Rhee1 1University Of Arizona,Trauma/Surgery/Medicine,Tucson, AZ, USA
Introduction: Aggressive management with blood products is known to improve organ donation in trauma patients. The aim of this study was to evaluate the impact of blood products transfusion ratios on solid-organ procurement rates. We hypothesized that 1:1 (PRBC: FFP) transfusion (RT) increases the solid organ donations in trauma patients.
Methods: We performed an 8 year retrospective analysis of all brain dead trauma patients at our level 1 trauma center. Patients who consented for organ donation and donated solid organs were included. Patients were stratified into two groups: patients with 1:1 transfusion (RT) and patients without 1:1 transfusion (No-RT). Outcome measures were: number and type of solid organs donated. Logistic regression analysis was performed.
Results: A total of 70 patients who donated a total of 318 solid organs were included. 57.1% (n=40) donors received 1:1 ratio transfusion. There was no difference in age (p=0.16), mechanism of injury (p=0.3), and systolic blood pressure on admission (p=0.1) between the two groups. Donors in the RT group were more likely to donate livers (82.5% vs. 63.3%, p=0.041) and lungs (42.5% vs. 17.2%, p=0.024), with an overall higher rate of solid organ donation [5±2.1 vs. 4.1±2.4, p=0.03] compared to patients in the No-RT group. RT was independently associated with increase in solid organ donation rates (OR [95%CI]: 1.13 [1.05-1.8], p=0.043).
Conclusion: Ratio based blood products transfusion increases solid organ donations in trauma donors. Aggressive resuscitation in 1:1 ratio in trauma patients who are deemed non survivable may improve conversion rates among eligible donors.