Surgeons utilizing more organs for transplant a year after AOC’s Donor Recovery Center opening

Sam Windham, M.D.The path University of Alabama at Birmingham physician Sam Windham, M.D., took to his role as the critical care specialist at the Alabama Organ Center’s Donor Recovery Center has had many turns.

In fact, Windham spent the better part of 2015 driving from one end of Alabama to the other — north and south, east and west — stopping at every hospital along the way with a cadre of AOC donor coordinators. The group was traveling the state roadways after the AOC decided to pursue constructing a Donor Recovery Center in cooperation with UAB Hospital, a novel approach to increase the number of organs recovered for transplant. The decision would make the AOC one of only eight procurement organizations in the country to have an in-house recovery center. It also would be the only one connected to an academic medical center like UAB.

The AOC engaged Windham to assist in improving donor management protocols for the new facility, which sent Windham and AOC donor coordinators on their mission around the state to identify best practices in organ donor management. All of this was done in an effort to fulfill every deceased donor’s wish — that their organs and tissues benefit as many people as possible upon their death.

“These hospitals really did a great job of supporting donor families and the mission of the AOC, especially in light of how complex donor management can be,” Windham said. “Donation can be very time-consuming and often requires a lot of hospital resources. I don’t know how they did it, personally. It was an incredible effort. And now, with the Donor Recovery Center in place, it really minimizes the challenges our other state hospitals may face when supporting the donation process.”

What Windham learned in his year on the Alabama roads was the intricacies of organ donor management, and it laid the foundation for improving donor management protocols, the task he was given by Devin Eckhoff, M.D., director of the Division of Transplantation in UAB’s School of Medicine. The results of these efforts have maximized the gift donation to those in need and have saved lives in record numbers.

More organs than ever were recovered and transplanted in Alabama in 2016. In December 2016 alone, 22 deceased donors donated organs through the AOC, a record number of donors in one month. Donations of almost all organs have increased during the past year; but the largest jump has been in lungs, which were a critical need when the facility opened. There were 20 deceased-donor lung transplants performed in the year prior to opening the center. From April 2016 to April 2017, that number has increased to 55. It is a significant achievement for a state in which there is no surplus of organs for those in need of transplant.

“We’ve never really had the opportunity to have a critical care specialist whose focus is to maximize the gifts of the donor like we have now with Sam, and the work he and the AOC coordinators have done has just been tremendous,” Eckhoff said. “We set a record for deceased donor donations in 2016, and the ability to recover these organs here — where the organ’s function is optimized prior to transplant — is a big reason for the success. It’s really a game-changer for organ donation in Alabama on many levels.”

The AOC moved into its new 8,710-square-foot office space in 2015. The facility includes two ICU bays, two organ and tissue recovery suites, and lab services.Chris Meeks, executive director of the AOC, says the opening of the Donor Recovery Center one year ago was essential to help the organization better meet the needs of both the donor and recipient communities.

“We wanted to provide a central place for organ and tissue donation so it could be a positive experience for the donor families and better enhance the wishes of the donor, so his or her organs and tissues could positively impact more lives,” Meeks said. “We want our donor families to know that out of their tragedy comes a lifesaving operation for their fellow man, and this facility gives us the best chance of honoring the wishes of the donor and donor family while helping people in need. It is an overwhelming feeling to see the impact that has been provided in the first year, and we hope it continues to grow.”

Windham, who grew up in Montgomery and completed his training at UAB, says the most rewarding part of his position with the AOC is meeting the donor families. And Windham says more families around the state are becoming comfortable with transferring their loved one to the Donor Recovery Center. He points to the increase in the number of families who have consented to move their loved ones to the recovery center for organ donation; 93 percent of the families approached about transferring their loved one to the Donor Recovery Center agree to do so — another testament to the willingness of families to help others in the midst of their own grief.

“I’ve had the opportunity to meet some wonderful families and really practice medicine in a special way in this position,” Windham said. “And working with the members of the AOC, the coordinators and transplant surgeons … It’s been incredibly rewarding.”

Before the Donor Recovery Center opened, transplant surgeons at UAB and AOC staff frequently traveled to hospitals throughout the state and beyond to recover organs from deceased donors. In this scenario, recovered organs are chilled and brought to the hospital where the transplant will occur. The length of time that passes during transport can potentially diminish the quality of the organs. Transferring donors to the AOC Donor Recovery Center — which occurs with the donor family’s permission and at no financial cost to the family — also opens much-needed ICU beds in the donor hospital and does not require the use of their operating room, easing their burden.

Deceased organ donation requires a person to be in a hospital and on a ventilator when he or she is pronounced brain dead. The manner in which a person dies determines what organs and tissues can be donated. In most cases, people who are evaluated for organ donation have suffered fatal head injuries resulting from a car accident, stroke or brain aneurysm. The organ and tissue evaluation and recovery are then performed at the recovery center. Afterward, the donor will be transported to the funeral home of the family’s choosing or to the state medical examiner for an autopsy if necessary.

When deceased donors are brought to the Donor Recovery Center, they receive personalized treatment from Windham, a team of nurses and the AOC clinical team. A bedside nurse is dedicated to taking care of the donor, monitoring blood pressure swings and heart rates. This highly personalized care, and the comfort provided to donor families by the AOC staff, has positively impacted families across the state.

“It’s really a team approach to taking care of the donors and their families, and the dedication and work of the AOC coordinators to helping these families really can’t be stated enough,” Windham said. “When we first opened the center, we had several successes back to back early on, and it really propelled us as a team. It’s been exciting to see our successes, and I know each of the coordinators in the AOC is looking to push those successes even higher so we can give more gifts to more people.”

Register to be an organ donor at alabamaorgancenter.org or visit organdonor.gov to find your state’s registry today.