Assessment of the Effect of Brain Death Etiologies on Organs Transplanted Per Donor

We assessed effects of brain death etiology on organ donation, particularly focusing on the number of organs transplanted per donor.

We evaluated 934 actual donors from 982 brain death cases at our center from April 2016 to July 2023. We analyzed donor cause of death, donor age, sex, blood group, time to consent, and hospital characteristics.

Among 934 actual brain death donors (63.6% male), mean age was 41.44 years. Cause of death was nontraumatic intracranial hemorrhage in 43.3% of cases, followed by trauma, hypoxia, cerebrovascular accident, toxicity, and brain tumor, respectively. Kidney, liver, heart, and lung donations occurred in 696 cases (74.5%), 809 (86.6%), 146 (15.6%), and 25 (3.4%), respectively. Donor cause of death significantly affected kidney donation (P < .001), with highest rates in trauma (83.7%), followed by brain tumors. Although cause of death did not affect liver transplant rates (P = .26), the highest rate was associated with trauma (89.9%), followed by toxicity. Difference in heart transplant rates among different causes of death was significant (P < .001), with highest rates in trauma cases. Similar to liver transplant, lung transplant was similar among different causes of death (P = .3). Organs transplanted per donor averaged 2.52 ± 1.13, with highest numbers associated with trauma (2.88 ± 1.07), followed by drug toxicity, brain tumors, hypoxia, nontraumatic intracranial hemorrhage, and cerebrovascular accident (P < .001). Compared with trauma, differences in organs transplanted per donor were significant for nontraumatic intracranial hemorrhage (mean difference 0.56; 95% CI, 0.39-0.74; P < .001), cerebrovascular accident (mean difference 0.58; 95% CI, 0.29-0.87; P < .001), and hypoxia (mean difference 0.50; 95% CI, 0.26-0.76; P = .002).

Understanding how cause of death influences donation can help improve organ donation practices and potentially increase the number of organs available for transplant.