Factors affecting organ donation rate during devastating brain injuries: a 6-year data analysis

Objectives: The discrepancy between organ donation rate and the number of patients waiting transplantation has been a common problem in Turkey. Intracerebral hemorrhage (ICH), traumatic brain injury (TBI), anoxic encephalopathy, stroke, and brain tumors comprise the majority of the causes of brain death. This study thus aimed is to analyze potential brain deaths and factors associated with organ donation among such patients. Material and methods: Medical records of 629 intensive care unit (ICU) patients with potentially devastating cerebral lesions from 01/2013 to 12/2018 were retrospectively analyzed. Clinical characteristics and the prevalence of consent for organ donation were then assessed. Results: Although possible brain death was considered in 102 patients, 21 (18%) died before diagnostic tests could be performed. Accordingly, the 81 potential organ donors had a donor conversion rate (DCR) of 30%. Causes of non-organ retrieval among potential donors included refusal of consent by relatives (89.5%), indecision of the family regarding donation or no relatives present (7%), and medical unsuitability for donation (3.5%). Conclusions: Our findings showed that refusal by the family was the most common reason for failure of deceased organ donations. To maximize the number of procured organs, transplant communities need to focus on increasing awareness regarding brain death and organ donation and establish strategies to increase consent obtained from the families.