Organ procurement organizations (OPOs) face mounting pressure to improve transplant outcomes and address the nation’s critical organ shortage. Integrating advanced practice providers (APPs) into donor management is an emerging strategy to close clinical gaps and enhance outcomes, yet limited research exists on their impact. This study analyzes APP role implementation across three OPOs to compare role responsibilities and assess their impact on organ donation performance.
A comparative analysis was conducted across three OPOs with established APP roles. Data collection included review of job descriptions, common practices, and Scientific Registry of Transplant Recipients (SRTR) performance data. Each organization's APP structure, educational requirements, and scope of practice were documented. SRTR data was analyzed for organ yield performance before and after APP implementation, focusing on observed versus expected yields and transplantation rates.
Across all organizations, APPs are responsible for direct clinical donor management, high-level clinical consultation, and advanced procedures such as bronchoscopies, central line placement and advanced airway management. Each organization utilizes APPs for active participation in quality improvement initiatives, developing evidence-based protocols and analyzing donation outcomes. Staff training program development and implementation is universal, with APPs creating educational curricula for clinical coordinators and hospital staff. Personnel mentoring and support provides clinical expertise and guidance during complex donor management. Clinical consultations are also provided to transplant centers, surgeons and referring hospitals regarding donor management optimization.
Notable differences emerged across organizations. Leadership responsibilities vary, with one OPO positioning APPs in formal management roles overseeing clinical operations, while others retained purely clinical positions. Additional variation was seen in strategic planning involvement, educational job requirements and reporting structures.
Performance data demonstrated substantial improvements following APP implementation. One OPO's reported organ yields dramatically exceeded expectations by 10 to 75 non-renal organs over an 18-month period. Another organization saw a 17.4% increase in organs transplanted per donor and 40.9% increase in lung transplants within 24 months of APP implementation.
This analysis supports the conclusion that APPs significantly improve organ donation outcomes by addressing critical gaps in clinical care and donor management. Standardized APP integration could increase organ utilization, enhance donor family experiences, and support sustainable workforce development strategies to help address organ shortage challenges.