The incidence of potential missed organ donors in intensive care units and emergency rooms: a retrospective cohort

Abstract

The number of heart-beating or DCD organ donors represented by missed referrals may represent up to 7.5 donors per million population. Improved documentation of brainstem reflexes and encouraging referral of patients suffering cardiac arrest to ICU specialists may improve donor numbers.

Year in review in Intensive Care Medicine 2013: II. Sedation, invasive and noninvasive ventilation, airways, ARDS, ECMO, family satisfaction, end-of-life care, organ donation, informed consent, safety, hematological issues in critically ill patients

“…Kutsogiannis and colleagues conducted a retrospective study of all deaths in ICUs and emergency departments that were not referred for evaluation for organ donation in four hospitals that cover a large geographic region in Canada over a 2-year period [63]. Of 2,931 deaths, 64 patients were identified as having a high probability of progression to brain death and 130 patients were assessed for possible donation after circulatory death.…”

Maternal organ donation and acute injuries in surviving children

“…This approach encompassed every acute care hospital in the region and represented all data available. We focused on the 3 diagnoses most commonly causing brain death, namely, traumatic brain injury, subarachnoid hemorrhage, and intracerebral bleeding [60][61][62]. We then restricted the sample based on 4 further criteria validated in prior research to define those cases most eligible for deceased organ donation, namely, age 59 years or younger, no disqualifying medical conditions (cancer, tuberculosis, and human immunodeficiency virus), mechanical ventilation starting at admission, and death within 1 week of admission [63].…”

Improving donor management and transplantation success: more research is needed

“…However, the number of organs that become available each year falls far short of providing for those in need, and thousands die each year waiting for transplantation. There are clearly many missed opportunities in the severely brain-injured population, many patients dying without the care teams pursuing the chance to give life to others through donation [3,4]. Donation after brain death (BD) still remains the main source for organs, and it carries the advantage of being performed in a relatively controlled setting with ongoing perfusion and oxygenation.…”