Liver transplant operating room cost containment: A five year review of the abbreviated open protocol

Background: Aggressive acceptance of donation after cardiac death (DCD) and extended criteria organ offers has led to an increased frequency of liver grafts which are ultimately declined due to poor organ quality or other unpredictable factors. Late offer declines result in significant financial loss secondary to operating room waste. The “Abbreviated Open Protocol” was implemented at our institution in 2018 to optimize cost savings while maximizing team readiness. This protocol involves both a reduction in the number of instruments initially opened and the staff required to be present upon notification of a liver offer acceptance.