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| Format: | Artículo Open Access |
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Wiley
2025
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| Online-Zugang: | https://onlinelibrary.wiley.com/doi/10.1111/ctr.70425 |
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- Venous Thromboembolism in Brain‐Dead Organ Donors: A Prospective Study of Prevalence, Management, and Impact on Organ Utilization and Recipient Outcomes Hailey M. Shepherd Nikki E. Rossetti Yun Zhu Bai Su‐Hsin Chang Yan Yan Alejandro De Filippis Anjana Delhi Meagan R. Pilar Ana A. Baumann Marci S. Damiano Andrew J. Bierhals Ramsey R. Hachem Chad A. Witt Rodrigo V. Guillamet Derek E. Byers Daniel Kreisel Ruben G. Nava Benjamin D. Kozower Bryan F. Meyers G. Alexander Patterson Gary F. Marklin Varun Puri Clinical Transplantation ABSTRACT Introduction Venous thromboembolism (VTE) is a known complication in critically ill patients, yet its prevalence in deceased organ donors and impact on organ recipients remain poorly characterized. Standardized guidelines for donor VTE assessment and management are lacking. Methods In this prospective observational study of brain‐dead donors at a regional organ recovery center (October 1, 2021–August 1, 2023), all donors underwent duplex ultrasonography and CT pulmonary angiography to screen for deep vein thrombosis (DVT) and pulmonary embolism (PE). Donors with VTE received prompt therapeutic anticoagulation. Organ recovery data and recipient 1‐year survival data were obtained from the Scientific Registry of Transplant Recipients (SRTR). Additionally, we surveyed US organ procurement organizations (OPOs) regarding VTE practices. Results Among 215 donors, 73 (34%) had VTE: 28% with DVT and 14% with PE. All VTE‐positive donors received prompt anticoagulation and no bleeding complications were observed. Organ recovery rates and 1‐year recipient survival did not differ by donor VTE status. Among 96 survey respondents from 41 of 56 U.S. OPOs, there was substantial variation in VTE practices, only 2% accurately estimated prevalence, and most respondents (83%) supported development of standardized guidelines. Conclusion VTE is common but underrecognized in brain‐dead donors. In this observational cohort, prompt diagnosis and short‐term management of donor VTE were feasible and were not associated with reduced organ utilization or early recipient outcomes, although the study was not designed to establish treatment efficacy. 10.1111/ctr.70425 http://onlinelibrary.wiley.com/termsAndConditions#vor