Donor conversion rates depend on the assessment tools used in the evaluation of potential organ donors.
OBJECTIVE
It is desirable to identify a potential organ donor (POD) as early as possible to achieve a donor conversion rate (DCR) as high as possible which is defined as the actual number of organ donors divided by the number of patients who are regarded as a potential organ donor. The DCR is calculated with different assessment tools to identify a POD. Obviously, with different assessment tools, one may calculate different DCRs, which make comparison difficult. Our aim was to determine which assessment tool can be used for a realistic estimation of a POD pool and how they compare to each other with regard to DCR.


METHODS
Retrospective chart review of patients diagnosed with a subarachnoid haemorrhage, traumatic brain injury or intracerebral haemorrhage. We applied three different assessment tools on this cohort of patients.


RESULTS
We identified a cohort of 564 patients diagnosed with a subarachnoid haemorrhage, traumatic brain injury or intracerebral haemorrhage of whom 179/564 (31.7%) died. After applying the three different assessment tools the number of patients, before exclusion of medical reasons or age, was 76 for the IBD-FOUR definition, 104 patients for the IBD-GCS definition and 107 patients based on the OPTN definition of imminent neurological death. We noted the highest DCR (36.5%) in the IBD-FOUR definition.


CONCLUSIONS
The definition of imminent brain death based on the FOUR-score is the most practical tool to identify patients with a realistic chance to become brain dead and therefore to identify the patients most likely to become POD.
Department of Intensive Care, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Yorick J
YJ
de Groot
Eelco F M
EF
Wijdicks
Mathieu
M
van der Jagt
Jan
J
Bakker
Hester F
HF
Lingsma
Jan N M
JN
Ijzermans
Erwin J O
EJ
Kompanje
D000328:Adult; D000368:Aged; D001926:Brain Death; D046148:Donor Selection / Q000379:methods* / Q000592:standards*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009426:Netherlands; D012189:Retrospective Studies; D020521:Stroke; D014019:Tissue Donors
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