Detection of potential organ donors: 2-year analysis of deaths at a German university hospital.
OBJECTIVE
In 2006, inhouse coordinators were introduced in all hospitals with intensive care units in Baden-Württemberg to improve organ donation. At our university hospital with a neurosurgery and a transplantation unit, we analyzed whether brain death certification and donation requests were always initiated (if possible).


METHODS
We retrospectively reviewed all 1312 hospital deaths from 2006-2007 by studying medical records and consulting with physicians. The possibility of organ donation was questioned.


RESULTS
Donation was requested among 68/702 deaths due to cerebral complications. A request was impossible in 8 cases. Consent for donation was obtained in 29 cases, and it was realized in 24 cases. In 14 cases of resuscitation from shock or cardiac failure, therapy was not continued because of questionable hemodynamic stability. In 17 cases admitted to peripheral wards and 19 to intensive care units death due to cerebral complications occurred within 48 hours, but medical records were not relevant for exclusion criteria for organ donation.


CONCLUSIONS
The detection of donors was not acceptable. In patients without a prognosis after resuscitation, further hemodynamic stabilization was frequently omitted, because organ donation had not been considered. In cases of donation requests the refusal rate was high. We initiated specific training.
Petersen
P
P
Department of General, Visceral and Transplantation Surgery, University of Tübingen, Tübingen, Germany. peter.petersen@med.uni-tuebingen.de
Fischer-Fröhlich
C-L
CL
Königsrainer
A
A
Lauchart
W
W
D001926:Brain Death; D002102:Cadaver; D002568:Certification; D019992:Databases as Topic; D005858:Germany; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D018579:Patient Selection; D012189:Retrospective Studies; D014019:Tissue Donors / Q000706:statistics & numerical data*