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Factors affecting organ donation rate during devastating brain injuries: a 6-year data analysis
Reyhan Arslantas1, Banu Eler Çevik1
1Anesthesiology and Reanimation Clinic, Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey.
Insights
Family refusal is the primary barrier to deceased organ donation in Turkey, significantly impacting organ transplant rates. Increasing public awareness and family consent strategies are crucial for improving organ procurement.
Area of Science:
- Medical Science
- Transplantation Medicine
- Public Health
Background:
- A significant gap exists between organ transplant demand and organ donation rates in Turkey.
- Brain death, often resulting from intracerebral hemorrhage, traumatic brain injury, anoxic encephalopathy, stroke, and brain tumors, is a critical area for organ donation potential.
Purpose of the Study:
- To analyze potential brain deaths in intensive care unit (ICU) patients.
- To identify factors influencing organ donation consent among potential donors in Turkey.
Main Methods:
- Retrospective analysis of medical records of 629 ICU patients with severe cerebral lesions (01/2013-12/2018).
- Assessment of clinical characteristics and organ donation consent prevalence.
Main Results:
- Out of 102 patients with potential brain death, 81 were identified as potential organ donors.
- The donor conversion rate (DCR) was 30%, with family refusal being the main reason for non-retrieval (89.5%).
- Other reasons for non-retrieval included family indecision/absence (7%) and medical unsuitability (3.5%).
Conclusions:
- Family refusal is the most significant obstacle to deceased organ donation.
- Enhancing public awareness of brain death and organ donation is essential.
- Developing effective strategies to increase family consent is vital for maximizing organ procurement.
Objectives:
The discrepancy between organ donation rate and the number of patients waiting transplantation has been a common problem in Turkey. Intracerebral hemorrhage (ICH), traumatic brain injury (TBI), anoxic encephalopathy, stroke, and brain tumors comprise the majority of the causes of brain death. This study thus aimed is to analyze potential brain deaths and factors associated with organ donation among such patients.
Material And Methods:
Medical records of 629 intensive care unit (ICU) patients with potentially devastating cerebral lesions from 01/2013 to 12/2018 were retrospectively analyzed. Clinical characteristics and the prevalence of consent for organ donation were then assessed.
Results:
Although possible brain death was considered in 102 patients, 21 (18%) died before diagnostic tests could be performed. Accordingly, the 81 potential organ donors had a donor conversion rate (DCR) of 30%. Causes of non-organ retrieval among potential donors included refusal of consent by relatives (89.5%), indecision of the family regarding donation or no relatives present (7%), and medical unsuitability for donation (3.5%).
Conclusions:
Our findings showed that refusal by the family was the most common reason for failure of deceased organ donations. To maximize the number of procured organs, transplant communities need to focus on increasing awareness regarding brain death and organ donation and establish strategies to increase consent obtained from the families.
