Analysis of conversion rate, organ procurement rate and influencing factors of organ donation: a single-center study in Fujian province / 器官移植

Objective To investigate the conversion rate, organ procurement rate and influencing factors of organ donation in a single center from Fujian province. Methods Baseline data of 182 potential organ donors of Fujian Medical University Union Hospital from November 2018 to June 2021 were retrospectively analyzed. The conversion rate of organ donation, baseline data of successful organ donors and the causes of failure of organ donors were identified. The organ procurement rate and the influencing factors of the number of organ donations were analyzed. Results Among 182 potential organ donors, 46 cases were successful organ donors with a conversion rate of 25.3%. In addition, 136 cases failed to donate organ. The main causes included disagreement from family members (58.1%), insufficient evaluation time (24.3%) and ineligible for donation criteria (17.6%). A total of 212 large organs and tissues were donated by 46 organ donors, including 88 kidneys, 42 livers, 15 lungs, 19 hearts and 48 corneas, with 4.6 large organs and tissues, and 3.6 large organs for each donor. Age, sex, native place, organ donation area and blood type were the influencing factors of the number of large organ donations. Organ donation area was the influencing factor of the number of tissue donations. Conclusions The conversion rate of organ donation is relatively low in a single center from Fujian province. Disagreement from family members is the main cause. Suitable potential organ donors should be selected for organ donation to improve the conversion rate and organ procurement rate of organ donation.

Successful Brain Dead Donor Management with CRRT: A Case Report / 대한구급학회지

Brain death results in adverse pathophysiologic effects in many brain-dead donors with cardiovascular instability. We experienced a brain-dead donor with continuous renal replacement therapy (CRRT) who was in a severe metabolic, electrolyte derangement and poor pulmonary function. The thirty-nine-year-old male patient with subarachnoid hemorrhage and intraventricular hemorrhage was admitted into the intensive care unit (ICU). After sudden cardiac arrest, he went into a coma state and was referred to as a potential organ donor. When he was transferred, his vital sign was unstable even under the high dose of inotropics and vasopressors. Even with aggressive treatment, the level of blood sugar was 454 mg/dl, serum K+ 7.1 mEq/L, lactate 5.33 mmol/L and PaO2/FiO2 60.3. We decided to start CRRT with the mode of continuous venovenous hemodiafiltration (CVVHDF). After 12 hours of CRRT, vital sign was maintained well without vasopressors, and blood sugar, serum potassium and lactate levels returned to 195 of PaO2/FiO2. Therefore, he was able to donate his two kidneys and his liver.

Potential Organ Donor Pool for Renal Transplantation in Intensive Care Unit and Emergency Room : Single center study for donor action program / 대한이식학회지

Organ shortage remains a main obstacle to the development of organ transplantation for end stage organ disease. Identification of potential donors is a key point of donation/transplantation process. We evaluated the entire potential organ donor developed in intensive care unit and emergency room to find out the way to improve the real donation program .Pro-and retrospective analysis were performed in death patient occurred in intensive care unit and emergency room between May. 1997 and Oct. 1997. There are 394 death patients in ICU and 324 in ER during study period. 293 patients (74.3%) were eliminated by age under 1 year or over 70 years, and medical disease unsuitable for organ transplantation. After a series of elimination due to no possibility of brain death or organ unsutability, 35 patients (8.9%) finally were found to be a acceptable potential donors for organ transplantation in ICU, and 3 (0.9%) in ER. 28 of the 35 potential donors (80.0%) were found in neurology or neurosurgery ICU. Causes of brain death in 35 potential donors were traumatic intracerebral injury in 10 (29.4%), and non traumatic intracranial cerebral catastrophe in 21 (61.8%). Actual multiorgan harvest was performed in 2 (5.7%) among 35 medically acceptable potential donors in ICU. Three (8.6%) among 35 potential donors refused organ donation by donor families, 29 (82.9%) could not be actual donors due to absence of any information on organ donation to families of donors. Conclusively organ donation rate and efficacy from the potential donor are very poor in this series. Comprehensive donor action programs including practical donor detection program with donor linker, education program to medical staff and public are mandatory to increase the cadaveric organ donation effectively.