Brain Death and Deceased Organ Donation in a Hospital in Istanbul, Turkey: The Effect of Early Identification of Brain Dead on Organ Donation Rates: A Retrospective Study

Introduction: The possibility of brain death (BD) among patients with a Glasgow Coma scale <7 must be considered by physicians who work in intensive care units. Deceased organ transplantation can be lifesaving so every BD patient should be seen as a potential donor. The aim of this study was to describe the causes of BD, rate of organ donation and to investigate the effect of diagnosis time on donation rates in our hospital over a 9-year period. Methods: After obtaining Institutional Ethics Committee approval, we conducted a retrospective review of patients who had sustained BD in our hospital between January 1, 2004 and January 1, 2013. Patients' age, methods used to diagnose BD, duration of survival after diagnosis, whether patients' family members gave consent to organ donation, and organ donation rates were reviewed. Results: Sixty patients were declared BD, of whom 21 (35%) were female and 39 (65%) were male. Their mean age was 28 years. Only 6 (10%) patients' families gave consent for donation. The most common cause of BD was traumatic brain injury (n=37, 62%). Internal carotid artery doppler ultrasonography was performed in 36 (60%) patients; cerebral angiography was performed in 14 (23%) patients; and electroencephalography was performed in two patients. The mean time from hospital admission to diagnosis of BD was 5.16 +/- 3.06 days overall; 5.5 +/- 0.4 days among non-donors; and 2.0 +/- 0.4 days among donors. The mean time from diagnosis of BD to death in non-donors was 2.4 +/- 0.3 days. In donors, the mean time from diagnosis of BD to harvesting of the patient's organs was 1.08 +/- 0.2 days. Conclusion: In our hospital, the rate of organ donation after BD is low. It is found that the time to confirm the diagnosis of BD was significantly shorter in donors than non-donors. It is believed that early diagnosis of BD is associated with an increased rate of family approval for organ donation.