{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T18:39:41Z","timestamp":1784831981090,"version":"3.55.0"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T00:00:00Z","timestamp":1707782400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nBackground<\/jats:title>\nOrgan donation shortage and in particular organ procurement is an international concern as the gap between the number of donors and recipients is steadily growing. Organ procurement is a chain of steps with donor identification and referral (ID&R) as the very first link in this chain. Failure of this step hinders the progress in the organ transplantation program.<\/jats:p>\n<\/jats:sec>\n\nObjectives<\/jats:title>\nOur study was conducted to evaluate and highlight the gap between the national system and the practice at the identification and referral (ID&R) step of the organ procurement chain in a single tertiary-care academic health center in Beirut: the Lebanese American University Medical Center\u2013Rizk Hospital (LAUMC-RH), and to appraise the literature for challenges at this step and for possible interventions for improvement based on the international experience.<\/jats:p>\n<\/jats:sec>\n\nMaterials and methods<\/jats:title>\nThis retrospective study was a descriptive case series of ICU and ED deceased patients at a single tertiary-care university hospital in Beirut. Patients\u2019 characteristics were collected from medical records for all patients who died between 2017 and 2019 while in the ICU or the ED and shared with the National Organization for Organ and Tissue Donation and Transplantation (NOD-Lb), for each subject separately, to decide on the donor status. All data collected from the patient cohort was analyzed using R version 3.6.1. Wilcoxon signed-rank test, chi-squared, and fisher-exact tests were used to compare differences in clinical characteristics in terms of donor status when appropriate.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nThis study served as 3 years audit of a single hospital experience, and it demonstrates failure to make any referrals to NOD-Lb and zero actual organ and tissue donations over the study period. The review of 295 deceased subjects\u2019 charts demonstrates 295 missed alerts to NOD-Lb and the overall missing of 5 organ and tissue donors and 24 cornea donors assuming the organ procurement chain of steps will continue uninterrupted after ID&R.<\/jats:p>\n<\/jats:sec>\n\nConclusion<\/jats:title>\nThe data gathered suggests the presence of an inefficient identification and referral system that is translated into a complete failure of reporting to NOD-Lb from LAUMC-RH. A systematic evidence-based approach to evaluate for the most cost-effective intervention to increase identification and referral rates is needed with a serious effort to examine and account for any inefficient implantation.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0295930","type":"journal-article","created":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T18:21:45Z","timestamp":1707848505000},"page":"e0295930","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Outcome analysis of brain-death referral to NOD-Lb: A retrospective chart review of a single hospital experience over 3 years"],"prefix":"10.1371","volume":"19","author":[{"given":"Hachem","family":"Araji","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnny","family":"Ayoub","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laudy","family":"Gebrael","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0575-7757","authenticated-orcid":true,"given":"Hiba","family":"Fala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elio Junior","family":"Feghali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwa","family":"Al Jardali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sleiman","family":"Iskandar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yana","family":"Said","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1354-4552","authenticated-orcid":true,"given":"Maria","family":"Nakhoul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0746-3687","authenticated-orcid":true,"given":"Wissam","family":"Faour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sola Aoun","family":"Bahous","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farida","family":"Younan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Stephan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,2,13]]},"reference":[{"key":"pone.0295930.ref001","unstructured":"government U. 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Vathsala","year":"2004","journal-title":"Transplantation proceedings"},{"issue":"S3","key":"pone.0295930.ref007","doi-asserted-by":"crossref","first-page":"S272","DOI":"10.1097\/01.tp.0000699864.69759.d7","article-title":"INTERNATIONAL REGISTRY IN ORGAN DONATION AND TRANSPLANTATION (IRODAT)\u2013 2019 WORLDWIDE DATA","volume":"104","author":"MP G\u00f3mez","year":"2020","journal-title":"Transplantation"},{"key":"pone.0295930.ref008","unstructured":"(NOD-lb) NOfOaTDaT. National Organization for Organ and Tissue Donation and Transplantation (NOD-lb)."},{"key":"pone.0295930.ref009","unstructured":"(NOD-lb) NOfOaTDaT. Lebanese deceased organ procurement system."},{"issue":"Suppl 1","key":"pone.0295930.ref010","doi-asserted-by":"crossref","first-page":"1","DOI":"10.6002\/ect.MESOT2021.L9","article-title":"The Dual Aspect of Deceased Organ Donation","volume":"20","author":"A. 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Public Private Partnership-based performance management in fragmented healthcare systems: the case of organ donation and transplantation in Lebanon Management de la performance bas\u00e9e sur un partenariat public-priv\u00e9 pour des syst\u00e8mes de sant\u00e9 fragment\u00e9s: le cas du don et de la transplantation d\u2019organes au Liban: Nantes Universit\u00e9; 2022."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0295930","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T18:21:59Z","timestamp":1707848519000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0295930"}},"subtitle":[],"editor":[{"given":"Stefan","family":"Grosek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,2,13]]},"references-count":28,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2,13]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0295930","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,13]]}}}