[Organ donation in a general hospital]

There is an acute shortage of donor organs for transplantation in The Netherlands. It is presumed that many potentially available organs are lost due to insufficient alertness. A retrospective study was made of the results of the procedure for obtaining permission for post-mortem donorship. Records of patients succumbed in the Intensive Care Unit in the period 1983-1987 were checked to ascertain whether these patients had met the current selection criteria for donorship. According to these criteria, 104 of the 531 deceased patients had been suitable. Death had been due to irreversible brain damage in 71 cases, to CVA in 29, to a primary brain tumour in three and to an intoxication in one. The donation procedure was followed in 53 cases of death. In 20 cases relatives refused permission and in 12 there were insuperable practical and technical difficulties. Relatives of 19 deceased patients were not asked for permission for post-mortem donorship. Once the procedure for obtaining permission for post-mortem donorship was implemented according to protocol and on a multidisciplinary basis, the proportion of cases in which requesting permission was omitted fell from 37% to 3%. Greater alertness of those involved to the possibilities of organ donation and good organization result in a growing number of organs available for transplantation, reducing an acute shortage.