Organ Procurement Organization Perspectives on Normothermic Regional Perfusion Practices: A Qualitative Interview Study.

BACKGROUND

Normothermic regional perfusion (NRP) increases the availability of quality transplantable organs. However, there are unresolved ethical challenges and variability in approaches to NRP facilitation across U.S. organ procurement organizations (OPOs). We sought to assess the landscape of OPO member perceptions on facilitating NRP.

METHODS

Semi-structured interviews with OPO executives assessed their experiences collaborating with hospital partners, communicating with donor families, and training hospital personnel to implement NRP. Qualitative themes were elicited through deductive and inductive thematic content analysis.

RESULTS

Twenty executives participated (53% participation rate). Five themes emerged: 1) comfort with allowing NRP procedures varied across and within donor hospitals and recipient transplant centers; 2) most participating OPOs lacked standardized operating procedures regarding case protocols and data collection protocols for NRP cases; 3) OPOs disclosed varied information about NRP during authorization conversations with donor families; 4) OPOs collaborated with donor hospitals and recipient transplant centers before, during, and after NRP cases; and 5) OPOs engaged in proactive educational efforts about NRP with partner hospitals before NRP cases are presented.

CONCLUSIONS

Our findings suggest that proactive, consistent, and cross-organization collaboration may help hospitals decide whether and how to adopt NRP and may help OPOs more effectively address challenges regarding the implementation of NRP. Future research should empirically assess NRP-related OPO practices.