Donor Action program in the Emilia-Romagna region of Italy.
BACKGROUND
The high demand for organs for transplantation necessitates enhancement of organ procurement activity worldwide.


OBJECTIVE
To detect critical areas in the organ donation process and to assess whether careful monitoring of deaths in each intensive care unit could improve rates of identification of brain death.


METHODS
Records of patients who died in intensive care units in the Emilia-Romagna region between July 1, 1998 and June 30, 2000 were reviewed through the Donor Action program.


RESULTS
Of the 2469 patients who died during the period studied, 1010 (40.9%) had severe brain damage, as indicated by a score of 3 on the Glasgow coma scale. A total of 857 patients with severe brain damage who had spent more than 6 hours in the intensive care unit (34.7% of all deaths) were considered as potential donors. Signs of brain death were observed in 383 (44.7%) of the 857 patients who died. Rates of identification of brain death increased from 36% to 55% during the study period.


CONCLUSIONS
Considering that the characteristics of the study population had not changed, we believe that the Donor Action program was an important factor leading to the observed improvement in identification of brain death.
Pugliese
Maria Rosa
MR
Transplant Referral Center, Emilia-Romagna Region.
Degli Esposti
Daniela
D
Dormi
Ada
A
Venturoli
Nicola
N
Mazzetti Gaito
Paolo
P
Sestigiani
Elena
E
Monti
Marzia
M
Ghirardini
Angelo
A
Costa
Alessandro Nanni
AN
Ridolfi
Lorenza
L
D000328:Adult; D000368:Aged; D001926:Brain Death / Q000175:diagnosis*; D002423:Cause of Death; D005190:Family / Q000523:psychology; D005260:Female; D015600:Glasgow Coma Scale; D006302:Health Services Research; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D012017:Referral and Consultation / Q000706:statistics & numerical data / Q000639:trends; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data*; D009927:Tissue and Organ Procurement / Q000458:organization & administration*