Estimating the organ donor potential in Denmark: a prospective analysis of deaths in intensive care units in northern...

To estimate the organ donor potential in Denmark we conducted a prospective registration of deaths in all intensive care units (ICUs), counting 15 ICUs and two neurosurgical ICUs in the four northern Danish counties, which cover a population of 1.64 million inhabitants or 30% of the Danish population. From September 1, 2000 till August 31, 2002, all deaths in the ICUs in 15 hospitals were recorded. Each case was evaluated locally postmortem with respect to medical suitability to organ donation. A total of 1655 deaths were recorded, corresponding to 504 deaths per million population per year (PMP). Median age was 70 years (0 to 99 years), 52% were more than 70 years, and 22% more than 80 years of age. The cause of death was cerebral lesion in 18% of the cases (neurosurgical ICUs: n = 182; ICUs: n = 110). By thorough medical record examination, the number of potential donors was estimated to be 169, corresponding to 51 PMP. The cause of death was cerebral lesion in 96% of the potential donors. Organ donation was performed in 43 cases (32 from neurosurgical ICUs and 11 from ICUs) or 13.1 PMP. Thus, 25% of the potential became organ donors. The major reason for nondonation was refusal from the relatives. Out of 127 questioned, the relatives refused in 62 cases (49%). By comparison, 74% of the general Danish population are willing to donate organs after death. The rate of nondetection of potential donors by the hospital staff could be estimated to 22%. In conclusion, the organ donor potential may allow for improvement in donation rates. An increased effort for donor hospitals is warranted. The motives for refusal by the relatives need elucidation.