Helen Ingrid Opdam1, William Silvester. 1. Department of Intensive Care, Austin Hospital, Studley Road, 3084 Heidelberg, Victoria, Australia. Helen.Opdam@austin.org.au
Abstract
OBJECTIVE: To quantify the potential for organ donation in Victoria and identify missed opportunities for organ donation. DESIGN AND SETTING: Prospective medical record audit of all deaths in 12 Victorian hospitals. MEASUREMENTS: Data on deaths, total potential donors, organ donors and outcome of requests for organ donation were collected. Patients in whom brain death was confirmed or likely to occur and in whom organ donation was not requested (unrealised potential donors) were classified by an independent panel. Rates of organ donation and unrealised donors were determined as a proportion of total potential donors and hospital deaths and the maximal potential organ donor rate was estimated. RESULTS: Of 5551 deaths, there were 112 potential donors, with 66 requests for organ donation resulting in 39 consents (consent rate of 59%) and 37 organ donors (33% of total potential donors; 0.7% of hospital deaths). Two consented potential donors did not donate due to failed physiological support (5%). There were 46 medically suitable unrealised potential donors; 3 with confirmed brain death. Approximately half of these patients had treatment withdrawn in the intensive care unit and half in the Emergency Department. The estimated maximal potential donor rate was 30 per million population. CONCLUSIONS: The potential for organ donation in Victoria is relatively low compared with previous estimates in Australia and overseas. An increase in the organ donation rate may be possible through increasing consent and the identification and support of potential donors. This would require substantial changes in clinical practice that have resource and ethical implications.
OBJECTIVE: To quantify the potential for organ donation in Victoria and identify missed opportunities for organ donation. DESIGN AND SETTING: Prospective medical record audit of all deaths in 12 Victorian hospitals. MEASUREMENTS: Data on deaths, total potential donors, organ donors and outcome of requests for organ donation were collected. Patients in whom brain death was confirmed or likely to occur and in whom organ donation was not requested (unrealised potential donors) were classified by an independent panel. Rates of organ donation and unrealised donors were determined as a proportion of total potential donors and hospital deaths and the maximal potential organ donor rate was estimated. RESULTS: Of 5551 deaths, there were 112 potential donors, with 66 requests for organ donation resulting in 39 consents (consent rate of 59%) and 37 organ donors (33% of total potential donors; 0.7% of hospital deaths). Two consented potential donors did not donate due to failed physiological support (5%). There were 46 medically suitable unrealised potential donors; 3 with confirmed brain death. Approximately half of these patients had treatment withdrawn in the intensive care unit and half in the Emergency Department. The estimated maximal potential donor rate was 30 per million population. CONCLUSIONS: The potential for organ donation in Victoria is relatively low compared with previous estimates in Australia and overseas. An increase in the organ donation rate may be possible through increasing consent and the identification and support of potential donors. This would require substantial changes in clinical practice that have resource and ethical implications.
Authors: E Sheehy; A Poretsky; S L Gortmaker; M J Evanisko; L Brigham; P Weber; S Gunderson; C L Beasley Journal: Transplant Proc Date: 1996-02 Impact factor: 1.066
Authors: H M Nathan; B E Jarrell; B Broznik; R Kochik; B Hamilton; S Stuart; T Ackroyd; M Nell Journal: Transplantation Date: 1991-01 Impact factor: 4.939
Authors: J F Thompson; C J McCosker; A D Hibberd; J R Chapman; J S Compton; J F Mahony; P J Mohacsi; G J MacDonald; P M Spratt Journal: Anaesth Intensive Care Date: 1995-02 Impact factor: 1.669
Authors: Peter Andrews; Elie Azoulay; Massimo Antonelli; Laurent Brochard; Christian Brun-Buisson; Geoffrey Dobb; Jean-Yves Fagon; Herwig Gerlach; Johan Groeneveld; Jordi Mancebo; Philipp Metnitz; Stefano Nava; Jerome Pugin; Michael Pinsky; Peter Radermacher; Christian Richard; Robert Tasker; Benoit Vallet Journal: Intensive Care Med Date: 2005-01-28 Impact factor: 17.440
Authors: Erwin J O Kompanje; Jan Bakker; François J A Slieker; Jan N M IJzermans; Andrew I R Maas Journal: Intensive Care Med Date: 2006-01-24 Impact factor: 17.440
Authors: Yorick J de Groot; Nichon E Jansen; Jan Bakker; Michael A Kuiper; Stan Aerdts; Andrew I R Maas; Eelco F M Wijdicks; Hendrik A van Leiden; Andries J Hoitsma; Berry H P H Kremer; Erwin J O Kompanje Journal: Intensive Care Med Date: 2010-03-16 Impact factor: 17.440
Authors: Yorick J de Groot; Eelco F M Wijdicks; Mathieu van der Jagt; Jan Bakker; Hester F Lingsma; Jan N M Ijzermans; Erwin J O Kompanje Journal: Intensive Care Med Date: 2011-01-26 Impact factor: 17.440
Authors: David Pilcher; Laura Gladkis; Byron Arcia; Michael Bailey; David Cook; Yael Cass; Helen Opdam Journal: Transplantation Date: 2015-10 Impact factor: 4.939