[Abdominal organ retrieval: strategies to improve quality]

[Surgical quality of organ retrieval in Bavaria]

Surgical problems during organ procurement may propagate complications in the transplant recipient. Ultimately, these problems may result in the complete loss of already scarce donor organs.Donor reports (Eurotransplant donor report) of 1,492 donor organs from January 2010 to August 2012 in the German Foundation of Organ Transplantation (DSO) region of Bavaria and corresponding organ quality forms were analyzed. Surgical problems were classified into 3 categories: (I) surgical problems recognized and reported by the donor surgeon, (II) surgical problems observed by the recipient surgeon but not reported by the donor surgeon and (III) surgical problems leading to organ loss. Surgical problems during this 20-month time period were reported for 17.6  % of organs; category I in 5.5  %, category II in 11.1  % and category III in 1  %. Damage of graft vasculature in 9.1  % was the most frequently reported problem. The mean error index for individual surgeons was 16  % and one out of the five Bavarian organ procurement centers had significantly more problems in all categories (30  %). Interestingly, surgeons who performed rapid retrieval procedures had more problems with quality than surgeons who took more time. Organ retrieval is prone to surgical problems. Especially in a system of organ transport, consistent reporting of surgical problems and quality assurance is needed to maintain and to improve surgical quality.