Is the Increase in DCD Organ Donors in the United Kingdom Contributing to a Decline in DBD Donors?
- 27 December 2010
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Transplantation
- Vol. 90 (12), 1506-1510
- https://doi.org/10.1097/tp.0b013e3182007b33
Abstract
Organ donation after brain death (DBD) has declined in the United Kingdom, whereas donation after cardiac death (DCD) has increased markedly. We sought to understand the reasons for the decline in DBD and determine whether the increase in DCD was a major factor. The UK Transplant Registry was analyzed to determine trends in organ donation. Data from the “Potential Donor Audit,” an audit of all patients younger than 76 years who died in noncardiothoracic UK intensive care units, was analyzed to identify trends in clinical demographics and management and to determine whether potential donors (DBD and DCD) were identified and appropriate steps were taken to enable organ donation. There were 7589 (12.8 per million of population [pmp]) deceased organ donors in the United Kingdom from 1999 to 2009. The total number of deceased donors increased by 16% (to 14.9 pmp), but DBD donors decreased from 744 to 612, and the overall increase in donors was due to an 8-fold increase in DCD donors (33 in 1999 to 2000, 288 in 2008 to 2009). Analysis of the Potential Donor Audit over the 5-year period 2004 to 2005 to 2008 to 2009 showed that the number of patients dying in intensive care units who were possibly brain stem dead (comatose, apparently apnoeic with unresponsive pupils) decreased from 1929 in 2004 to 2005 to 1495 in 2008 to 2009 (22.5% reduction). The proportion of potential DBD donors who became donors increased from 45% to 51%. There is no evidence that the increase in DCD donors has contributed directly to the decline in DBD, which reflects a decrease in the number of patients with brain death.Keywords
This publication has 16 references indexed in Scilit:
- Analysis of factors that affect outcome after transplantation of kidneys donated after cardiac death in the UK: a cohort studyThe Lancet, 2010
- Current status of donation after cardiac death liver transplantationCurrent Opinion in Organ Transplantation, 2010
- Lung transplantation with donation after cardiac death donors: Long-term follow-up in a single centerThe Journal of Thoracic and Cardiovascular Surgery, 2010
- Non-heart-beating organ donationBritish Journal of Surgery, 2009
- Best interests and potential organ donorsBMJ, 2008
- Decompressive Surgery for the Treatment of Malignant Infarction of the Middle Cerebral Artery (DESTINY)Stroke, 2007
- Outcomes of Pancreas Transplantation in the United States Using Cardiac-Death DonorsAmerican Journal of Transplantation, 2006
- Potential for organ donation in the United Kingdom: audit of intensive care recordsBMJ, 2006
- Report of a National Conference on Donation after Cardiac DeathAmerican Journal of Transplantation, 2006
- Donor characteristics associated with reduced graft survival: an approach to expanding the pool of kidney donors1Transplantation, 2002