Analysis for Influencing Factor of the Organ Procurement Rate in Brain Dead Donors

Park, Chang Kyun; Park, Kwang Min; Lee, Young Joo; Hwang, Shin; Kim, Ki Hun; Ahn, Chul Soo; Moon, Deog Bok; Oh, Ki Bong; Cho, Sung Hun; Ha, Tae Yong; Kim, Kun Kook; Kim, Yeon Dae; Lee, Sung Gyu

Abstract

PURPOSE
The number of patients waiting for organ transplantation continues to grow as technical and pharmacological advances increase the success rate of transplantation procedures, while organs are donated by few of the thousands of potential donors who die every year. The organ transplantation continues to be the best treatment for many end-stage diseases of the heart, liver, kidneys, and other organs. Many organ procurement failures have been attributed to a failure to identify patients with nonsurvivable central nervous system injury or disease as potential organ donors or failure to maintain a hemodynamic stability or failure to request consent for donation from next to kin. This study has been done for investigating the factors that influence the organ procurement rate in brain dead donors.
METHODS
Of the 259 brain dead donors in the Asan Medical Center, from January 1991 to April 2003, 189 brain dead donors donated solid organs excluding conea. We retrospectively reviewed the medical records and the data of the transplantation center. A hemodynamic stability is defined as systolic blood pressure more than 90~100 mmHg with the use of low-dose vasopressor (dopamine less than 10microgram/ kg/min).
RESULTS
From January 1991 to April 2003, the procurement rates of liver, heart, kidney and pancreas were 39% (n=75), 40% (n=76), 97% (n=184) and 17% (n=33), respectively. The procurement rates according to age were 26% in <20 years (n=49), 30% in 21~30 years (n=56), 20% in 31~40 years (n=37), 19% in 41~50 years (n=36), and 5% in >50 years (n=11). The major. causes of death among potential organ donors were traffic accident (59%) and cerebrovascular events (33%). In traffic accident, the procurement rates of liver, heart, kidney and pancreas were 42% (n=47), 37% (n=41), 98% (n=109) and 16% (n=18), and in cerebrovascular events, 33% (n=21), 38% (n=24), 97% (n=61) and 19% (n=12). Multiple organs were donated in the hemodynamically stable donors.
CONCLUSION
Aggressive resuscitation and hemodynamically stabilization of all brain dead donors are important factors that may increase procurement rates.