Introduction: In current healthcare, a multi-disciplinary approach is taken in critical care to ensure all specialties can offer their training and expertise in the care of every patient. In organ donation, and specifically donor management, having a team of Procurement Transplant Coordinators (PTCs) that is comprised similarly ensures that optimal results can be achieved through a varied knowledge base. Traditionally, this has been heavily weighted with Registered Nurses with critical care experience. We propose that including Registered Respiratory Therapists (RRTs) as PTCs can broaden the base of expertise of the team and maximize successful lung transplantation. Additionally, the incorporation of different modes and modalities of ventilation with a physiological approach to lung recruitment has successfully proven an increase in lung optimization.  

Research significance: To fully understand the positive impact of RRTs in lung recruitment, we looked at the upward trend of the Horowitz index for Lung Function (P/F ratio) with a subject OPO and how it correlated with an increasing number of PTCs that are licensed and registered Respiratory Therapists. At the end of 2019, 2 RRTs were added to the donor management team as PTCs. In the beginning of 2020, 2 additional RRTs were added to the donor management team.

Methodology: We reviewed data showing the increase in successful lung recruitment after the addition of Respiratory Therapists to the team. Comparing the results from previous years, data showed a related increase in lung optimization per year with Respiratory Therapists working as Procurement Transplant Coordinators.    

Results: Evidence demonstrates a correlation of the increase in lung procurement and transplantation numbers mirroring an increase in RRTs in the role of PTCs. Improvements to PF ratios were compared at the beginning of the case to the final PF ratio prior to OR. From 2018-2019 there were 89 donors who were brought to the operating room for transplant. The median and mean improvement to PF ratios were 0.83 and 0.83, respectively. From 2020-2021 there were 75 donors who were brought to the operating room for transplant. The median and mean improvement to PF ratios were 1.04 and 1.32, respectively. This proved a 25.3% increase for the median PF ratio and a 59% increase to the average PF ratio.

Conclusion: Our research supports that PTCs who are licensed and experienced Respiratory Therapists being proficient in lung physiology, recruitment, and ventilation strategies have a direct increase in lung optimization. Having specific organ expertise, RRTs have proven to be a vital asset while sharing knowledge with the entire multi-disciplinary team.