title: The Influence of End-of-Life Care on Organ Donor Potential.
abstract: Many patients with acute devastating brain injury die outside intensive care units and could go unrecognized as potential organ donors. We conducted a prospective observational study in seven hospitals in the Netherlands to define the number of unrecognized potential organ donors outside intensive care units, and to identify the effect that end-of-life care has on organ donor potential. Records of all patients who died between January 2013 and March 2014 were reviewed. Patients were included if they died within 72 h after hospital admission outside the intensive care unit due to devastating brain injury, and fulfilled the criteria for organ donation. Physicians of included patients were interviewed using a standardized questionnaire regarding logistics and medical decisions related to end-of-life care. Of the 5170 patients screened, we found 72 additional potential organ donors outside intensive care units. Initiation of end-of-life care in acute settings and lack of knowledge and experience in organ donation practices outside intensive care units can result in under-recognition of potential donors equivalent to 11-34% of the total pool of organ donors. Collaboration with the intensive care unit and adjusting the end-of-life path in these patients is required to increase the likelihood of organ donation.
authors.affiliation: Department of Intensive Care Medicine, Radboud university medical center, Nijmegen, The Netherlands.|Dutch Transplant Foundation, Leiden, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Witjes
authors.affiliation: Department of Intensive Care, St. Elisabeth hospital, Tilburg, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Kotsopoulos
authors.affiliation: Department of Intensive Care, Catharina hospital, Eindhoven, The Netherlands.
authors.forename: I H F
authors.initials: IHF
authors.lastname: Herold
authors.affiliation: Department of Intensive Care, Catharina hospital, Eindhoven, The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: Otterspoor
authors.affiliation: Department of Intensive Care, Jeroen Bosch hospital, Den Bosch, The Netherlands.
authors.forename: K S
authors.initials: KS
authors.lastname: Simons
authors.affiliation: Department of Intensive Care, Rijnstate hospital, Arnhem, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: van Vliet
authors.affiliation: Department of Intensive Care, Rijnstate hospital, Arnhem, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: de Blauw
authors.affiliation: Department of Intensive Care, Gelderse Vallei hospital, Ede, The Netherlands.
authors.forename: B
authors.initials: B
authors.lastname: Festen
authors.affiliation: Department of Intensive Care, Maxima medical center, Veldhoven, The Netherlands.
authors.forename: J J A
authors.initials: JJA
authors.lastname: Eijkenboom
authors.affiliation: Dutch Transplant Foundation, Leiden, The Netherlands.
authors.forename: N E
authors.initials: NE
authors.lastname: Jansen
authors.affiliation: Department of Intensive Care Medicine, Radboud university medical center, Nijmegen, The Netherlands.
authors.forename: J G
authors.initials: JG
authors.lastname: van der Hoeven
authors.affiliation: Department of Intensive Care Medicine, Radboud university medical center, Nijmegen, The Netherlands.
authors.forename: W F
authors.initials: WF
authors.lastname: Abdo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001926:Brain Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013727:Terminal Care; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000458:organization & administration* / Q000592:standards*
keywords: donors and donation: deceased; donors and donation: donor evaluation; health services and outcomes research; organ procurement and allocation; organ transplantation in general