J Korean Soc Transplant.  2011 Jun;25(2):106-112.

Analysis of the Potential Deceased Donors in the Neurosurgical Intensive Care Units of Korea

• Lee S
• Ahn C
• Kim SI
• Han DJ
• Cho WH

Abstract

BACKGROUND
The shortage of donor organs is the main problem that needs to be solved in Korea as well as in other countries. To expand the donor pool, we retrospectively reviewed the brain-dead patients who expired without organ donation in the neurosurgical intensive care units (NICU) and evaluated the potential deceased donors (PDDs).
METHODS
Between January 2008 and December 2008, PDDs who expired without organ donation in the NICU were recruited from 52 secondary or tertiary referral hospitals in Korea. The data of a total 2,288 PDD cases were collected from the questionnaire. Of these, 1,980 cases were eligible for analysis.
RESULTS
There were 1,166 males (58.9%) and 793 females (40.1%) with a mean age of 57.6+/-18.0 years (21.2% in the 5th decade; 21.0% in the 6th decade). The most common cause of death of PDDs was cerebrovascular accident (n=1,034; 52.2%). Glasgow Coma scale was 3 in 23.1% and 4 in 12.1% of the PDDs. Craniotomy was performed in 996 patients (50.3%). Sepsis developed in 276 patients (14.0%) among the total PPDs. Diagnostic procedure for assessment of brain death was performed in 194 patients (9.8%). The seroprevalence of HBsAg and HCVAb was 1.7% and 0.6%, respectively. The mean AST/ALT level on admission and after brain death were 80.9+/-344.9/49.0+/-162.19 and 308.6+/-1,485.2/142.5+/-596.27 IU/L, respectively. Uriney protein level was normal in 1,221 patients (61.7%) after brain death. Of the 1980 PDDs, 19 patients (1%) donated their organs for transplantation.
CONCLUSION
Only a small percentage (1%) of PDDs in the NICU donated their organs in Korea. We suggest that continuous and active donor action is needed to increase organ donation from the potential deceased donors.

Keyword

Brain death; Tissue and organ procurement; Intensive care units; Neurosurgery

MeSH Terms

Brain Death
Cause of Death
Craniotomy
Critical Care
Female
Glasgow Coma Scale
Hepatitis B Surface Antigens
Humans
Intensive Care Units
Korea
Male
Neurosurgery
Surveys and Questionnaires
Retrospective Studies
Sepsis
Seroepidemiologic Studies
Stroke
Tertiary Care Centers
Tissue and Organ Procurement
Tissue Donors
Tuberculin
Hepatitis B Surface Antigens
Tuberculin

Figure

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  Fig. 1. Age and sex distribution.

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  Fig. 2. Cause of patients who expired without organ donation in neurosurgical intensive care unit. Abbreviations: CVA, cerebral vascular accident; TA, traffic accident.

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  Fig. 3. Glasgow coma scale distribution of expired patients. Abbreviation: GCS, glasgow coma scale.

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  Fig. 4. HBV Ag status of expired patients.

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  Fig. 5. Anti-HCV Ab status of expired patients.

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  Fig. 6. Proteinuria of expired patients.

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  Fig. 7. AST/ALT of expired patients.

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  Fig. 8. Total bilirubin expired patients.

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  Fig. 9. Craniotomy of expired patients.

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  Fig. 10. Sepsis of expired patients.

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  Fig. 11. Organ donation from expired patients.

Reference

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