The number of available organs for transplantation in the United States continues to fall short of the increasing number of people waiting for suitable organs. Critical care nurses are in a unique position and play an important role in the management of transplant donors and recipients. This issue of Critical Care Nursing Quarterly focuses on organ transplantation: the efforts to increase the number of available organs for donation, managing critically ill patients to improve survival to transplant, management of cardiac and liver transplant patients, and the forensic or legal implications surrounding transplantation.
Shafer's article describes the efforts to improve the organ conversion rates through a national collaborative focused on sharing best practices to the largest hospitals. Shafer describes the partnership between the government, the donation, and transplantation communities and shares the process and subsequent improvements in donation rates that accompanied the efforts.
Chillcott et al describe their 20-year experience with a critical care response team that provides rapid initiation of extracorporeal life support (ECLS). The article covers the history of their program, indications for ECLS, program development, guidelines, staff education, and their competency program.
For more than 40 years, cardiac transplantation has been a treatment option for patients with terminal heart failure. McCalmont and Ohler present a comprehensive account of the patient selection criteria, evaluation process, and the organ allocation system. The article also provides information on some of the latest technology available to provide a bridge to transplantation.
LaPointe Rudow and Goldstein detail the available surgical options for liver transplant patients, describing surgery, potential complications, and optimum patient management. Critical care nurses are a valuable asset to the multidisciplinary team in managing the postoperative patient and monitoring for complications.
Dougherty's article describes roles and responsibilities of critical care nurses in the identification of potential donors. Information regarding the unique contributions of the forensic nurse in ensuring medical and legal requirements surrounding transplantation is shared.
The contributions from the authors in this issue provide a valuable resource for critical care nurses regarding transplantation.
Finally, we are pleased to publish two evidence-based practice reports. Campbell reports on the value of nurse champions on compliance with a sepsis screening protocol. Swadener-Culpepper, Skaggs, and VanGilder discuss clinical and financial outcomes of using continuous lateral rotation therapy. These articles provide some exciting insights into improving practice in the critical care environment.
Cynthia T. Walsh, MSN, RN, CCRN
Issue Editor