Factors Related to the Low Organ Donation Rate - A Transplant Management Approach

Abstract

Objectives: To assess the capacity to identify potential organ donors in a university hospital in Maranhão (MA). Methods:!e study is a retrospective, quantitative cohort based on the documentary analysis of medical records of deceased patients in the adult intensive care units (ICUs) of a university hospital in MA from 2018 to 2019. Screening Instrument I from the Organización Nacional de Trasplantes (ONT) of Spain, based on Avedis Donabedian and validated in Brazil, was used to identify potential donors with clinical signs of brain death (BD). !e analysis involved reviewing medical records and applying BD diagnostic criteria, according to Conselho Federal de Medicina Resolution nº 2,173 of 2017. A total of 312 records were analyzed, resulting in 38 with signs of BD, classi"ed as escapes due to identi"cation and maintenance failures of potential donors. Results: Of the 312 evaluated records, 21 from 2018 and 17 from 2019 (totaling 38) presented clinical signs of BD and were selected for detailed auditing.Additionally, it was identi"ed that 31.1% of the escapes or losses of potential donors resulted from deaths not identi"ed as BD, generating previously unknown indicators. !e tool revealed that patients undergoing surgical treatment for brain tumors and cerebrovascular diseases have a higher likelihood of evolving to BD. !ese patients, usually admitted to the general ICU, should receive special attention in daily assessments due to their high potential to become organ donors. Conclusion:!e audit highlighted the need for improvements in the identi"cation and maintenance of potential donors, as well as in reducing family refusals, to increase the number of effective donations.