CONTEXT: Donors showed poor glucose control in the period between declaration of brain death and organ recovery. The level of hyperglycemia in the donors was associated with a decline in terminal renal function. OBJECTIVE: To determine whether implementation of a quality improvement project improved glucose control and preserved renal function in deceased organ donors. METHODS: Data collected retrospectively included demographics, medical history, mechanism of death, laboratory values, and data from the United Network for Organ Sharing. RESULTS: After implementation of the quality improvement project, deceased donors had significantly lower mean glucose concentrations (mean [SD], 162 [44] vs 212 [42] mg/dL; P<.001) and prerecovery glucose concentration (143 [66] vs 241 [69] mg/dL; P<.001). When the donor cohorts from before and after the quality improvement project were analyzed together, mean glucose concentration remained a significant predictor of terminal creatinine level (P<.001). Multivariate analysis of delayed graft function in kidney recipients matched to donors indicated that higher terminal creatinine level was associated with delayed graft function in recipients (P<.001). CONCLUSION: The quality improvement project improved donor glucose homeostasis, and the data confirm that poor glucose homeostasis is associated with worsening terminal renal function.
CONTEXT: Donors showed poor glucose control in the period between declaration of brain death and organ recovery. The level of hyperglycemia in the donors was associated with a decline in terminal renal function. OBJECTIVE: To determine whether implementation of a quality improvement project improved glucose control and preserved renal function in deceased organ donors. METHODS: Data collected retrospectively included demographics, medical history, mechanism of death, laboratory values, and data from the United Network for Organ Sharing. RESULTS: After implementation of the quality improvement project, deceased donors had significantly lower mean glucose concentrations (mean [SD], 162 [44] vs 212 [42] mg/dL; P<.001) and prerecovery glucose concentration (143 [66] vs 241 [69] mg/dL; P<.001). When the donor cohorts from before and after the quality improvement project were analyzed together, mean glucose concentration remained a significant predictor of terminal creatinine level (P<.001). Multivariate analysis of delayed graft function in kidney recipients matched to donors indicated that higher terminal creatinine level was associated with delayed graft function in recipients (P<.001). CONCLUSION: The quality improvement project improved donorglucose homeostasis, and the data confirm that poor glucose homeostasis is associated with worsening terminal renal function.
Authors: Allan J Collins; Robert N Foley; Blanche Chavers; David Gilbertson; Charles Herzog; Kirsten Johansen; Bertram Kasiske; Nancy Kutner; Jiannong Liu; Wendy St Peter; Haifeng Guo; Sally Gustafson; Brooke Heubner; Kenneth Lamb; Shuling Li; Suying Li; Yi Peng; Yang Qiu; Tricia Roberts; Melissa Skeans; Jon Snyder; Craig Solid; Bryn Thompson; Changchun Wang; Eric Weinhandl; David Zaun; Cheryl Arko; Shu-Cheng Chen; Frank Daniels; James Ebben; Eric Frazier; Christopher Hanzlik; Roger Johnson; Daniel Sheets; Xinyue Wang; Beth Forrest; Edward Constantini; Susan Everson; Paul Eggers; Lawrence Agodoa Journal: Am J Kidney Dis Date: 2012-01 Impact factor: 8.860
Authors: Glen A Franklin; Ariel P Santos; Jason W Smith; Susan Galbraith; Brian G Harbrecht; R Neal Garrison Journal: Am Surg Date: 2010-06 Impact factor: 0.688
Authors: Friedrich K Port; Jennifer L Bragg-Gresham; Robert A Metzger; Dawn M Dykstra; Brenda W Gillespie; Eric W Young; Francis L Delmonico; James J Wynn; Robert M Merion; Robert A Wolfe; Philip J Held Journal: Transplantation Date: 2002-11-15 Impact factor: 4.939
Authors: Sri G Yarlagadda; Steven G Coca; Richard N Formica; Emilio D Poggio; Chirag R Parikh Journal: Nephrol Dial Transplant Date: 2008-12-22 Impact factor: 5.992
Authors: Michael E Hagan; Daniel McClean; Cassandra A Falcone; Jeffrey Arrington; Donna Matthews; Carrie Summe Journal: Prog Transplant Date: 2009-09 Impact factor: 1.065