Brain stem death and organ donation--11 years on.
BACKGROUND
We studied previously patterns of organ donation in a teaching hospital. Eleven years later we repeated the study to investigate how patterns had changed. We also wanted to see whether non-heart beating donation was being practised in our intensive care units.


METHODS
All deaths were prospectively audited to identify potential heart beating and non-heart beating organ donors. The actual organ donors and reasons for not donating were identified.


RESULTS
Overall, there was a significant reduction in the number of potential organ donors in the 11-yr period. This was accompanied by an increase in refusal rates by relatives from 10 to 29%, and a decrease in refusal rates by the coroner from 28 to 11%.


CONCLUSIONS
In this hospital the number of potential and actual organ donors has fallen in 11 yr. This is a combination of decreasing numbers of patients becoming brain dead and increased relative refusal rate. It has only been partially offset by a more liberal attitude of the coroner and non-heart beating donors.
D001294:Attitude to Health; D001926:Brain Death; D003422:Critical Care / Q000379:methods; D004739:England; D005190:Family / Q000523:psychology; D006801:Humans; D011446:Prospective Studies; D009927:Tissue and Organ Procurement / Q000379:methods / Q000639:trends*