Causes of donation failure and improvement measures analyzed based on data from domestic deceased donors in 2019

Area of Science:

• Transplantation Science
• Public Health Policy
• Medical Ethics

Background:

• In 2019, South Korea recovered 1,630 organs from 450 brain death donors, but only 18.1% of potential donors were successfully utilized.
• A significant 67.0% family refusal rate highlights the need for analyzing causes and developing countermeasures for organ donation.
• 203 cases died during early donor evaluation, necessitating focused attention and potential system improvements.

Purpose of the Study:

• To analyze the low organ donation success rate in South Korea.
• To identify critical time points and potential delays in the brain death confirmation process.
• To propose strategies for increasing deceased organ donation rates.

Main Methods:

• Retrospective analysis of national organ donor data from 2019.
• Evaluation of the time intervals involved in the brain death declaration process.
• Review of reasons for donation failure after consent.

Main Results:

• Only 18.1% of potential brain-dead donors resulted in successful organ recovery.
• Significant time is spent in brain death management: 11.5 hours for investigations, 5.3 hours for electroencephalogram, and 5.9 hours for committee conclusion.
• 67 cases failed donation post-consent due to death or poor organ quality, suggesting potential benefits from shortened management times.

Conclusions:

• Reducing brain death management time can improve organ quality and increase recovery numbers.
• Accurate identification of potential donors and efficient confirmation processes are vital.
• Enhancing public awareness and implementing donation after circulatory death are necessary to increase deceased donors.