Respiratory therapists can take their careers in many different directions, but one not often discussed is the organ recovery coordinator. It’s a job that nurses mainly assume, but other clinicians can get into the act as well, including RTs.
At Texas State University, therapists prepare for this role by enrolling in the respiratory care program’s organ procurement organization (OPO) internship.
“Respiratory therapists are in an ideal position because they take care of every patient who meets the organ donor referral criteria due to their patients’ mechanical ventilation needs,” said Nicholas Henry, MS, RRT, RRT-ACCS, RRT-NPS, AE-C, director of clinical education and associate professor in the program.
The internship is one of several 160-hour internships offered by the respiratory care program. During their senior year, students must select two — one must be in the adult critical care setting, and the other can be in an area of specialization chosen by the student.
Henry’s interest in developing the OPO internship grew out of his own experience as an organ recovery coordinator with TOSA before joining the Texas State faculty. Through that relationship, he has provided education to the community regarding organ donation, conducted research, and collaborated with TOSA personnel to develop a pulmonary management workshop for the TOSA organ recovery coordinators.
Since organ recovery coordinators work on an on-call basis, students who opt for the internship must be willing and able to work on a flexible basis. Given the complicated nature of the work, they also need to demonstrate confidence in their critical thinking abilities and professionalism.
“They will be working in different ICUs throughout the Austin and San Antonio area and will be communicating with nurses, physicians, and transplant teams,” Henry said.
So far, only a handful of students have completed the OPO internship, but one, Ann Marie Pezzuto, BSRC, RRT, has gone on to work as a full-time organ procurement coordinator with TOSA. She explains what the job entails.
“On average, organ recovery coordinators devote about 40-60 hours a week, sometimes more,” she said. “We work 24-hour shifts in which we dedicate our time to
triaging and evaluating patients who are referred to us to see if they are medically suitable to donate organs.”
The job involves an individual evaluation of each of the patient’s organs to determine whether or not the level of functioning meets the criteria for transplant. Coordinators then following the patient, communicating with the care team twice daily to obtain updates on the patient’s clinical status and plan of care.
“If a family elects to transition to comfort care, or if a patient progresses to brain death, we travel to the facility where the patient is located and speak with the family to offer the opportunity of donation,” she continued. “Once authorization for donation is obtained, we medically manage the donor while communicating with the transplant centers as a way to identify potential recipients.”
The process can take several days. Once recipients are located for each organ deemed suitable for transplant, the coordinator works with the transplant teams to schedule an operating room and time for the procurement.
“The procurement process typically takes anywhere from 4-6 hours, depending on which organs are being recovered for transplant,” Pezzuto said. “There is nothing more amazing than watching days-worth of hard work and dedication to honor the family’s and their loved one’s decision to donate, and seeing how many lives will be changed in a matter of hours.”
Right for the job
Nick Henry says the internship at Texas State had to be put on hold due to the pandemic, but they hope to restart it soon. He believes RTs are right for the job, particularly when the transplant will involve the lungs.
“Lungs are difficult to recover for organ transplantation because of a variety of pulmonary conditions such as aspiration, trauma, and previous pulmonary disease,” he said. “Respiratory therapists working as organ recovery coordinators have expertise in advanced ventilator settings, lung recruitment maneuvers, and bronchopulmonary hygiene, which can help improve the function of lungs and improve the opportunity for lung donation.”
While therapists who take on this role will have to learn many additional skills, he believes their core expertise in pulmonary health can improve the rate of lung donation and transplantation. The internship at Texas State is helping to highlight the role they can play.
“The collaboration between the department of respiratory care and TOSA provides the opportunity for our students to experience an evolving role as well as gain a deeper insight into critical care medicine,” he said. “It provides an opportunity to learn more
about the entire critical care management of patients, such as vasopressor titration, interpretation of lab work, and calculation of inputs/output.”
Ann Marie Pezzuto says working as an organ recovery coordinator has many rewards.
“Not only do we fight for these families who are losing a loved one to know about the amazing opportunity they have through organ donation, but we are also advocating for the many recipients that are waiting on the transplant waiting list,” she says. “These recipients never know how much time they have left; however, they are hopeful for the opportunity to receive an organ transplant and have the ability to create additional precious memories with their family.”
That in itself is priceless. “This is what keeps me grounded and continues to drive my passion to save lives through the power of organ donation,” she says.