DNA and Banner Health create
Arizona’s first donor care center 

OVERVIEW: 

In November 2023, Donor Network of Arizona (DNA) finalized an agreement with Banner Health to create an organ donor care center (DCC) at Banner – University Medical Center Phoenix (B-UMCP). It is the first of its kind for Arizona’s organ donation program. That means deceased organ donors in some circumstances will be transported to this DCC for continued donor care and the recovery of donated organs for transplantation.  

DNA began a five-year strategic plan in 2022, which included exploration of a DCC as one of five strategies to improve our ability to carry out our mission. Through the strategic planning process, it became clear that collaboration with a Phoenix-based hospital to establish a DCC would magnify the generosity of donors and their families, expand our impact on lives saved through the vital gift of organ donation for transplantation, and would increase effectiveness for an everchanging Arizona health care system. 

BENEFITS OF THIS CHANGE: 

Process efficiency: 

This change addresses an inconsistency in resources during a donor case depending on variables at any given hospital, related to its size and location: access to services (based on expertise and time of day), staffing shortages and OR space, to name a few. The DCC will initially have critical care space for four donors and workspaces exclusively for DNA.  

The originating hospital (from where the donor is referred), in turn, will benefit by offering priority to other types of surgeries for OR scheduling as a result of our team no longer occupying them, as well as freeing up ICU space the donor would occupy ahead of a scheduled organ recovery. 

Increasing lives saved: 

Organ Transplant Quality: Having donations take place in a fully controlled environment, with identified resources and support in place, can increase the quality of clinical management and better control the timing of recovery. We predict the result will be more organs viable for transplantation. 

Increased Organ Transplants: Controlling timing allows for better navigation of requirements for all transplant surgeons involved in the recovery. Because logistic hurdles for recovery and transplant are significantly reduced, there’s the potential to increase total organs recovered and transplanted. 

DEFINITIONS: 

• Originating hospital – Referring donor hospital where the patient was admitted and subsequently died. 
• Transport – Process of moving donor from originating hospital to DCC, not to be confused with transfer from one hospital unit to another within the same facility 

FREQUENTLY ASKED QUESTIONS: 

Which patients will be transported to the DCC? 

• Brain dead patients, 16 or older will be considered for transport to the DCC. 
• Initially, patients from B-UMCP ICUs will be transported to the DCC. 
• Following successful testing, we will expand to additional Phoenix-based Banner Health hospitals, beginning with two additional hospitals before expanding to all. 
• Eventually, the plan is to roll out to all Phoenix-based hospitals and potentially statewide. 
• We will not transport a patient deemed too unstable for transport, rather we will work with the originating hospital to facilitate donation. If the patient becomes stable enough for transport during donor care, we may explore transport at that time. 

Have other OPOs made a similar change to establish hospital based DCCs? 

• Multiple OPOs have adopted this best practice working in collaboration with a hospital including: 
  • ARORA – Arkansas OPO  
  • LifeLink of Georgia – Georgia OPO  
  • LifeSource – Minnesota, North Dakota and South Dakota OPO 
  • Gift of Hope Organ & Tissue Donor Network – Illinois OPO 
  • Tennessee Donor Services – Tennessee OPO 
  • Donor Network West – California OPO 
• The establishment of a DCC for an OPO is a recommendation from NASEM as part of a longer list of suggestions the committee advised OPOs to execute within five years of its publishing. View NASEM’s fill report at Realizing the Promise of Equity in the Organ Transplantation System (2022). You may download the free PDF as a guest user. 

What timeline would the transport of a brain dead donor be?  

• It will be DNA’s responsibility to initiate transport. We are required to give B-UMCP a three-hour notice of an incoming donor patient. We would make that notification to begin the transfer process as soon as possible once we have identified a transfer candidate and after a brain death declaration by a hospital physician.

What prompted this change? 

• Process and efficiency improvement is what our team does behind the scenes all the time. The inspiration for a constant effort to improve stems from our commitment to better serve and care for donors, their families and waiting list candidates who rely on our work.
• DNA has long centralized tissue recovery at a few locations in Phoenix and Tucson and has seen the long-term benefits.  

Will this process extend to other hospitals, and could there be more than one DCC?  

• We predict this will extend to all hospitals in Arizona in the future.
• DNA leadership will continue exploring the idea of more than one DCC, while monitoring the benefits and areas of opportunities of this first DCC with B-UMCP. 

Will the DCC transport process expand to DCD donors, too?  

• This process update only includes brain dead donors, 16 or older. Donation after circulatory death (DCD) cases are currently not part of this change in donation protocol. We do not currently have a timeline associated with the transport of DCD donors. 
• As a part of establishing this strategy for DNA to further our mission, we interviewed multiple OPOs that already have a DCC in place. Each recommended beginning with the transport of brain-dead donors. 

For further questions, please reach out to your hospital’s donation coordinator or email contact.us@dnaz.org.