Donor Conversion and Procurement Failure: The Fate of Our Potential Organ Donors

Abstract

Of all patients screened for organ donation, only a fifth actually donated. Denial of consent was the major potentially preventable cause of procurement failure, whereas hemodynamic instability accounted for only a small percentage of donor losses. With such low conversion rates, the preventable causes of procurement failure warrant further study.

Imprecise definitions of starting points in retrospectively reviewing potential organ donors causes confusion: call for a reproducible method like ‘imminent brain death’

“…When these differences occur within one study, caused by inclusion of two extra brainstem reflexes, what does this imply for DCRs from international data that depend on different definitions for heart‐beating potential? The large numbers of published articles worldwide on reviews of medical records from ICU deaths indicates the interest in identifying numbers of potential of organ donors [1–3,5,7–10,16–23], but the DCRs’ cannot be compared.…”

Lost potential of kidney and liver donors amongst deceased intracerebral hemorrhage patients

“…The conversion of eight out of 59 theoretical donors (14%) is far less than the 51% conversion rate amongst mechanically ventilated patients reported in the whole of Finland and other European countries [4], in the USA (40%) [12], UK (40%-45%) [13,14] and Germany (47%) [5]. The true conversion of eight actual donors amongst the 20 brain dead patients (40%) equals previous audits.…”

Hypothermia in organ donation

“…16 Hypothermia is known to be associated with multisystem failure and organ dysfunction. 17Y19 Furthermore, hypothermia delays the diagnosis of brain death, which has been shown to decrease organ procurement rates.…”