Loss of Potential Donors Due to Hemodynamic Maintenance

Transplant Proc. 2020 Jun;52(5):1226-1230. doi: 10.1016/j.transproceed.2020.02.020. Epub 2020 Mar 17.

Abstract

Background: Statistics indicate low utilization of potential donors, where only about one-third are converted into actual donors. In this context, it is plausible to argue that many potential donors are not hemodynamically stable for harvesting multiple organs since the procedures for maintaining parameters of stability may not be a priority in all critical care units in the country. Thus, it is necessary to identify losses of potential donors due to hemodynamic maintenance since reversing this situation enable minimizing mortality on waiting lists.

Methods: This was a retrospective quantitative study, based on information sent to Notification, Organ Procurement, and Distribution Centers by reporting hospitals in the state of São Paulo, using the Death Information Form regarding the specifics of each death registered in their intensive care units and emergency rooms.

Results: Hemodynamic instability contributed to a loss of 537 potential donors, corresponding to 61.9% of failures to obtain potentially transplantable organs.

Conclusion: Of the 33,175 cases of death reported, 867 fulfilled the criteria to be possible and potential donors (ie, patients diagnosed with brain death). Among these cases, 38.1% fulfilled Criterion 3 (ie, they were hemodynamically stable and in ideal organ donation condition). Therefore, this study concludes that losses due to maintenance occurred in 537 brain dead patients. This finding highlights the importance of investing in the development of competencies of professionals who work in critical care units to increase the number of multiple organ and tissue donors and reduce waiting lists.

MeSH terms

  • Brain Death
  • Critical Care / statistics & numerical data
  • Data Collection
  • Donor Selection*
  • Emergency Service, Hospital / statistics & numerical data
  • Hemodynamics*
  • Humans
  • Hypotension / complications
  • Intensive Care Units
  • Organ Transplantation
  • Oxygen / chemistry
  • Retrospective Studies
  • Tissue Donors / statistics & numerical data*
  • Tissue and Organ Harvesting
  • Tissue and Organ Procurement / methods*
  • Transplants
  • Waiting Lists

Substances

  • Oxygen