Abstract:
INTRODUCTION:Organ donation after brain death (DBD) has declined in the United Kingdom, whereas donation after cardiac death (DCD) has increased markedly. We sought to understand the reasons for the decline in DBD and determine whether the increase in DCD was a major factor. METHODS:The UK Transplant Registry was analyzed to determine trends in organ donation. Data from the "Potential Donor Audit," an audit of all patients younger than 76 years who died in noncardiothoracic UK intensive care units, was analyzed to identify trends in clinical demographics and management and to determine whether potential donors (DBD and DCD) were identified and appropriate steps were taken to enable organ donation. RESULTS:There were 7589 (12.8 per million of population [pmp]) deceased organ donors in the United Kingdom from 1999 to 2009. The total number of deceased donors increased by 16% (to 14.9 pmp), but DBD donors decreased from 744 to 612, and the overall increase in donors was due to an 8-fold increase in DCD donors (33 in 1999 to 2000, 288 in 2008 to 2009). Analysis of the Potential Donor Audit over the 5-year period 2004 to 2005 to 2008 to 2009 showed that the number of patients dying in intensive care units who were possibly brain stem dead (comatose, apparently apnoeic with unresponsive pupils) decreased from 1929 in 2004 to 2005 to 1495 in 2008 to 2009 (22.5% reduction). The proportion of potential DBD donors who became donors increased from 45% to 51%. CONCLUSION:There is no evidence that the increase in DCD donors has contributed directly to the decline in DBD, which reflects a decrease in the number of patients with brain death.
journal_name
Transplantationjournal_title
Transplantationauthors
Summers DM,Counter C,Johnson RJ,Murphy PG,Neuberger JM,Bradley JAdoi
10.1097/TP.0b013e3182007b33subject
Has Abstractpub_date
2010-12-27 00:00:00pages
1506-10issue
12eissn
0041-1337issn
1534-6080journal_volume
90pub_type
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