Power of One: Synergy Between the TSICU and OPO Boosts Organ Transplantation

Introduction: The gap between organ supply and demand continues to widen. In response to this ongoing shortage and the growing complexity of donor management, NASEM released a landmark report in 2022. Among its key recommendations was the establishment of Donor Care Units (DCUs)—specialized environments designed to optimize organ recovery, support donor families, and drive clinical innovation. In alignment with this vision, the OPO partnered with the TSICU at an academic Level 1 trauma to create the first DCU. The program has evolved into a high-performing recovery model—achieving consistent transplant success and zero discarded organs, setting a new standard for donor care and transplantation outcomes.


Methods: Brain-dead donors within the Greater Metro Area were transferred to the DCU from acute care hospitals following authorization for donation. Surgical intensivists provided 24/7 in-house consultation and facilitated timely completion of bedside procedures necessary for organ allocation. Outcomes including OPTD, O:E transplant ratios, and organ discard rates were compared between brain-dead donors managed in the DCU and those within the same DSA who were not transferred to the DCU (non-DCU).


Results: 87 brain-dead donors aged 16 years or older were transferred to the DCU, resulting in 274 organs transplanted and 232 lives saved. The O:E transplant ratio for DCU donors is 1.16, compared to 1.03 for non-DCU donors within the same Donor Service Area. The OPTD for DCU-managed donors is 4.00, exceeding both the national average (3.0–3.75) and the local non-DCU average (3.1). Since April 2025, no organs recovered from DCU donors have been discarded.


Conclusions: Since January 2024, brain-dead donors aged 16 and older have been transferred from acute care hospitals to the DCU, a dedicated space developed through collaboration between the OPO and TSICU team. The growing number of transfers—spanning multiple healthcare systems—reflects earned trust and strong support from the broader medical community. Among several promising outcomes, one metric stands out: zero organ discards. The creation of the first DCU in the Southwest has demonstrated the power of a unified mission and deeply collaborative care—transforming organ donation through clinical innovation and shared purpose.