Deceased organ donation in Brazil: how can we improve?
METHODS
We retrospectively analyzed the registry data from one organ procurement organization obtained between January 1 and December 31, 2005.


RESULTS
Among the 378 potential deceased donors, 182 (48.2%) were lost, mainly due to clinical conditions (27%) or cardiac arrest (19.3%). Of the remaining 196 (51.8%) potential donors, family consent was obtained in 94 cases (48%). Family refusal was higher for potential donors aged between 18 and 59 years (70%). Of the 94 donors, 72 (77%) had their organs harvested. Cardiac arrest before harvesting (56.5%) and positive viral serology (26%) were the main reasons for further losses. The mean donor age was 40 years and 51% were men. Causes of death were cerebral vascular accidents (55.5%), cranium encephalic traumas (29%), and gun shot wounds (8%). The rate of organ donation was 100% for kidneys and livers, 96% for hearts, 86% for pancreatas, 76% for lungs, and 74% for corneas. After assessment of organ viability, 94% of corneas, 91% of kidneys, and 88% of livers were transplanted, but only 52% of pancreata and 42% of hearts. The most frequent causes of discarded organs were age and concomitant donor infection.


CONCLUSIONS
Areas for potential improvements are: (1) earlier identification and adequate maintenance of potential donors; (2) campaigns for organ donation; and (3) careful evaluation of donated organs and selection of a suitable population to increase utilization of expanded criteria organs.
Medina-Pestana
J O
JO
Hospital do Rim e Hipertensao - Nephrology Division, Universidade Federal de Sao Paulo, Sao Paulo, Brazil. medina@hrim.com.br
Sampaio
E M
EM
Santos
T H F
TH
Aoqui
C M
CM
Ammirati
A L
AL
Caron
D
D
Galvao-Pereira
M
M
D001926:Brain Death; D001938:Brazil; D006323:Heart Arrest; D006801:Humans; D018579:Patient Selection; D012042:Registries; D012189:Retrospective Studies; D020521:Stroke / Q000401:mortality; D014019:Tissue Donors / Q000145:classification*; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data*; D014948:Wounds, Gunshot / Q000401:mortality