Brain Death and Organ Donation Rates in a City Hospital: A Retrospective Study

Abstract

Introduction Although organ donation rates have been increasing over the years, the lack of organ donation remains the most important problem in transplantation. By changing strategies, the Cekirge City Hospital in Bursa/Osmangazi has achieved a cadaveric donor rate of 24.9 per one million individuals in 2016; this rate is 21.5 in England, 20.9 in Norway, 14.7 in the Netherlands, and 10.6 in Germany. Methods Brain death cases were retrospectively evaluated between January 1, 2011, and December 31, 2016. Results There were a total of 137 brain death cases. Three of eight cases, five of 12 cases, three of 13 cases, 13 of 25 cases, 16 of 29 cases, and 21 of 50 cases became a donor in 2011, 2012, 2013, 2014, 2015, and 2016, respectively. Conclusion Deceased organ donation rates have increased over the years; however, the number of brain dead patients and the acceptance of organ donation by families have been increasing, but the percentage of brain death donations did not increase. We suggest that the reason for this situation is that well-trained and educated physicians diagnose more brain death cases and have a greater desire to treat end-stage organ failure patients, but the tendency of the public to donate has not increased as hoped. Donation and transplantation rates may be increased with a combination of well-trained, educated, and dedicated physicians with public education.

Retrospective analysis of the patients with brain death diagnosis in the last 5 years in our hospital

“…Gender varies between countries in patients diagnosed with brain death. In our study, 52.3% of patients diagnosed with brain death were female gender; studies conducted in our country reported that the majority of those diagnosed with brain death are male sex 7,8,9,10 . Aghighi et al 11 reported from Iran that the rate of brain death in males was 2.1 times that of females and Han et al 12 in a study conducted in South Korea; women were more diagnosed with brain death (65%).…”

The Incidence of Brain-Dead Donors Based on Screening and Management Led by Intensivists

“…In our hospital, dedicated intensivists participate and act as intermediaries between these trainees and the professional organ procurement team. In a single-center study, well-trained and educated physicians contributed to the increased acceptance of organ donation by patients’ families [ 18 ]. It is speculated that the explanation and participation of the organ donation procedure by a dedicated intensivist, who is more empathetic than the third expert, will contribute to an increase in the organ donation rate.…”

Muslim American physicians’ views on brain death: Findings from a national survey

“…Since physicians serve as decision-makers and advisors in clinical care, it is vital to understand how physicians’ values are challenged by “brain death.” Accordingly, studies done in both Poland and Germany have linked lower organ procurement rates to physicians’ hesitancy in declaring a patient as brain dead even when clear clinical signs were present. [ 7 8 ] One study done in Saudi Arabia among Arab Muslim physicians found that it was permissible to execute any necessary intervention in the event of cardiac arrest for 5% of the “brain dead” patients. [ 9 ] More significantly, a study in Turkey found that 38.2% of the Muslim physicians felt that patients who were diagnosed as “brain dead” should be kept alive for as long as possible.…”