(P-IT-12) Utilizing Organ-Specific Medical Record Numbers to Support Normothermic Machine Perfusion Devices in Solid Organ Transplantation

As normothermic machine perfusion (NMP) devices become integral in evaluating donor organ viability for transplantation, transplant centers must overcome logistical challenges such as ordering blood and reserving operating rooms to open the devices. The electronic health record (EHR) and laboratory information system (LIS) that manage these activities require patient medical record numbers (MRN). Yet, these actions for the organ must be performed independently of both donor and recipient health records, maintaining confidentiality between the two persons.

Study

Design/Methods:

A large, tertiary-care, academic medical center convened a multidisciplinary workgroup including members from the Transplant Center Administration, Perioperative Services, Blood Bank, Finance, and Informatics. The group collaborated to create a workflow that would support blood product ordering and traceability, transplant reporting requirements, OR prioritization and reservation, and billing procedures. The workflow must preserve donor and recipient confidentiality, support transfer of organs to and receival from external hospitals, and ensure the ability to segregate organ-associated health information from patient censuses and from health information networks.

Results/Findings:

The workgroup initiated the pre-emptive creation of MRNs to be assigned to transplant organs using a novel “patient” naming system to allow quick identification of organ type. The MRNs permit timely scheduling of ORs, efficient ordering and pickup of blood, issuance of type-specific components, and traceability of organs from donor to recipient via United Network for Organ Sharing identifier (UNOS ID) inclusion in non-searchable organ MRN records. The MRNs allowed communication between the EHR and LIS to support the use of the electronic blood product administration module for transfusion to organs. Furthermore, the novel patient-naming convention and patient-type information were used to exclude the organs from automated billing work queues and from censuses and health information networks. Since implementation in November 2023 through March 2024, this process was used on 24 occasions and resulted in 11 successful transplants.

Conclusions:

Organ-specific MRNs allows the creation of workflows based on existing processes in the EHR and LIS. This is a viable solution for transplant centers to overcome the logistical challenges associated with the use of NMP devices in a manner compliant with both transplantation and blood banking regulatory requirements. This innovative approach is applicable to other forms of organ perfusion and may be adapted for future transplant technologies.