Elective intensive care unit admissions for organ donation in patients with terminal brain glioma: Case report

Author:

Waller Shohei F12ORCID,O’Brien Yvette34,Seah Jo-An56,McLachlan Sue-Anne17,Dowling Anthony J17

Affiliation:

1. Oncology Department, St.Vincent’s Hospital Melbourne, VIC, Australia

2. Medical Oncology Department, The Peter MacCallum Cancer Centre, Melbourne, VIC, Australia

3. Department of Critical Care Medicine, St.Vincent’s Hospital Melbourne, Fitzroy, VIC, Australia

4. DonateLife Victoria, Australia

5. Palliative Care Department, St.Vincent’s Hospital Melbourne, Fitzroy, VIC, Australia

6. Oncology Department, Northern Health, Epping, VIC, Australia

7. The Department of Medicine, The University of Melbourne, VIC, Australia

Abstract

Despite being eligible, only 26 patients with primary brain cancer became organ donors from 2009 to 2018 in Australia. We describe two patients with high grade gliomas who successfully donated their organs after obtaining first-person consent in the outpatient setting by careful multidisciplinary planning and an elective intensive care unit admission for organ donation. Barriers and facilitators were examined based on these experiences and suggestions for future practices are explored. The recommended practices include: 1. Systematic incorporation of organ donation into advance care planning. 2. Integrating organ donation organisation coordinators into advance care planning. 3. Standardization of donor care and clear communication and collaboration between treatment teams. 4. Support and involvement of the medical treatment decision maker. 5. Identification of clinical triggers for admission to hospital and intensive care unit. These two cases illustrate that with careful coordination and involvement from a multidisciplinary team, successful organ transplantation outcomes are possible.

Publisher

SAGE Publications

Reference33 articles.

1. The Transplantation Society of Australia and New Zealand. Clinical Guidelines for Organ Transplantation from Deceased Donors, Version 1.12, https://tsanz.com.au/storage/Guidelines/TSANZ_Clinical_Guidelines_Version-112_06-FINAL-PRINT.pdf (2023, accessed 6 February 2024).

2. Australia and New Zealand Organ Donation Registry. Annual Reports, https://www.anzdata.org.au/wp-content/uploads/2020/10/s04_profile_2019_v1.0_20201028.pdf (2020, accessed 20 June 2021).

3. Cancer Australia. Brain Cancer in Australia Statistics, https://www.canceraustralia.gov.au/affected-cancer/cancer-types/brain-cancer/brain-cancer-australia-statistics (2020 accessed 20 June 2021).

4. Deceased Donors With a Past History of Malignancy: An Organ Procurement and Transplantation Network/United Network for Organ Sharing Update

5. Risk of tumor transmission in transplantation from donors with primary brain tumors: an Australian and New Zealand registry report

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