Purpose: This study investigates the feasibility and success rates of integrating Vascular Composite Allographs (VCA), specifically larynx and associated tissues, as organ donation options within a US-based Organ Procurement Organization (OPO). By training Family Services Coordinators (FSCs) and assessing donor criteria and funeral arrangements, the study aims to provide insights for optimizing organ procurement processes and expanding VCA donation options.
Methods: A single US-based OPO was approached by a transplant center within their region who received approval for a larynx VCA program. The OPO trained their FSCs on the indication for a larynx VCA transplant, as well as the procurement procedure and post-mortem reconstruction. FSCs included “larynx and associated tissue” as another option for organ donation on the anatomical gift form. Donor criteria was limited by the transplant program to brain dead donors between the ages of 18-50.
Results: 264 approaches for organ donation were made from the single US-based OPO from April 16, 2023, through November 30, 2023. Authorization for organ donation was obtained from 202 (76.5%) of families approached. Out of the 202 authorizations, 41 (21%) met criteria for larynx and associated tissue. Of the 41 potential donors who met criteria, authorization for larynx and associated tissue was obtained from 30 (73%) families. Out of the 11 families who declined larynx and associated tissue, 8 (73%) declined tissue as well, and 3 (27%) authorized tissue but specifically declined larynx and associated tissue due to having an open casket viewing.
Conclusion: The study demonstrates that, with effective education and training, Family Services Coordinators can achieve remarkably high authorization rates for Larynx Vascularized Composite Allografts. Notably, funeral arrangements and services play a crucial role in influencing the authorization of VCA, with considerations for open casket viewings impacting the authorization of larynx and associated tissues.