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Updated: Feb 28, 2026
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Published on: June 18, 2021
Irreversible Total Loss of Brain Function and Organ Donation in Patients with Aneurysmal Subarachnoid Hemorrhage
Malte Mohme1, Thomas Sauvigny1, Jörn Grensemann2
1Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Insights
A significant portion of patients with aneurysmal subarachnoid hemorrhage (aSAH) who experience irreversible loss of brain function (ILBF) become organ donors. This study identified key patient characteristics associated with organ donation after aSAH.
Area of Science:
- Neurology
- Neurosurgery
- Transplantation Medicine
Background:
- Aneurysmal subarachnoid hemorrhage (aSAH) is a critical condition with high mortality.
- Irreversible loss of brain function (ILBF), often leading to brain death, is a common outcome in fatal aSAH cases.
- Organ donation following ILBF presents a complex but vital pathway for saving lives.
Purpose of the Study:
- To determine the prevalence of organ donation among patients diagnosed with ILBF after aSAH.
- To characterize the clinical and epidemiological factors associated with organ donors in the aSAH population.
Main Methods:
- Retrospective analysis of anonymized clinical data from 395 patients treated for aSAH.
- Assessment of organ donation consent rates and clinical parameters for ILBF diagnosis.
- Evaluation of demographic factors influencing organ donor conversion.
Main Results:
- 18.0% of aSAH patients died, with 50.7% of these diagnosed with ILBF.
- 32.4% of patients with ILBF became organ donors, contributing 85 organs (kidneys, livers, hearts, lungs, pancreas).
- Male patients and those under 60 years old were more likely to become organ donors.
Conclusions:
- ILBF is a frequent diagnosis in fatal aSAH, requiring specialized neurointensive care.
- This study elucidates the characteristics and prevalence of organ donation following aSAH-induced ILBF.
- Understanding these factors can optimize organ procurement strategies in neurocritical care settings.
Objective:
Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening disease with an often fatal clinical course leading to irreversible loss of brain function (ILBF) (i.e., brain death). The purpose of this study was to assess the prevalence and characteristics of patients with aSAH who became organ donors after diagnosis of ILBF.
Methods:
Anonymized clinical data sets of 395 patients treated for aSAH at a university medical center from January 2011 to December 2016 were retrospectively analyzed. Prevalence of consent for organ donation and clinical characteristics, including parameters for diagnosis of irreversible loss of brain function, were assessed.
Results:
After initial admission to the intensive care unit, 18.0% of patients (n = 71) died (Glasgow Outcome Scale score 1). Intracerebral hemorrhage occurred in 42.3% of patients who died, aneurysmal rebleeding occurred in 19.7%, and intraventricular hemorrhage occurred in 87.3%. In 50.7% of patients who died (n = 36), ILBF was diagnosed, and 32.4% (n = 23) of these patients became organ donors. In 55.6%, additional diagnostic electroencephalography was performed. Male patients significantly more often became organ donors than female patients (P = 0.008). ILBF with subsequent organ donation was predominantly seen in patients <60 years old. A total 85 of organs were explanted for donation, including 42 kidneys, 21 livers, 3 pancreas, 11 hearts and 8 lungs.
Conclusions:
ILBF in the setting of fatal aSAH is a prevalent diagnosis with complex demands for neurointensive care physicians. We demonstrated the clinical characteristics and epidemiologic factors of patients with aSAH converting to organ donors.
