Analysis of the Potential Deceased Donors in the Neurosurgical Intensive Care Units of Korea

Samuel Lee; Curie Ahn; Il Kim Soon; Jong Han Duck; Hyun Cho Won

doi:10.4285/jkstn.2011.25.2.106

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Lee, Ahn, Soon, Duck, and Won: Analysis of the Potential Deceased Donors in the Neurosurgical Intensive Care Units of Korea

Original Article

J Korean Soc Transplant 2011;25(2):106-112.

Published online: 10 June 2011

DOI: https://doi.org/10.4285/jkstn.2011.25.2.106

Analysis of the Potential Deceased Donors in the Neurosurgical Intensive Care Units of Korea

Samuel Lee, M.D.¹, Curie Ahn, M.D.², Il Kim Soon, M.D.³, Jong Han Duck, M.D.⁴, Hyun Cho Won, M.D.⁵

¹Department of Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine Korea

²Department of Internal Medicine, Seoul National University College of Medicine Korea

³Department of Surgery, Yonsei University College of Medicine Korea

⁴Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul Korea

⁵Department of Surgery, Keimyung University College of Medicine, Daegu, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims

The shortage of donor organs is the main problem that needs to be solved in Korea as well as in other countries. To expand the donor pool, we retrospectively reviewed the brain-dead patients who expired without organ donation in the neurosurgical intensive care units (NICU) and evaluated the potential deceased donors (PDDs).

Methods

Between January 2008 and December 2008, PDDs who expired without organ donation in the NICU were recruited from 52 secondary or tertiary referral hospitals in Korea. The data of a total 2,288 PDD cases were collected from the questionnaire. Of these, 1,980 cases were eligible for analysis.

Results

There were 1,166 males (58.9%) and 793 females (40.1%) with a mean age of 57.6±18.0 years (21.2% in the 5th decade; 21.0% in the 6th decade). The most common cause of death of PDDs was cerebrovascular accident (n=1,034; 52.2%). Glasgow Coma scale was 3 in 23.1% and 4 in 12.1% of the PDDs. Craniotomy was performed in 996 patients (50.3%). Sepsis developed in 276 patients (14.0%) among the total PPDs. Diagnostic procedure for assessment of brain death was performed in 194 patients (9.8%). The seroprevalence of HBsAg and HCVAb was 1.7% and 0.6%, respectively. The mean AST/ALT level on admission and after brain death were 80.9±344.9/49.0±162.19 and 308.6±1,485.2/142.5±596.27 IU/L, respectively. Uriney protein level was normal in 1,221 patients (61.7%) after brain death. Of the 1980 PDDs, 19 patients (1%) donated their organs for transplantation.

Conclusion

Only a small percentage (1%) of PDDs in the NICU donated their organs in Korea. We suggest that continuous and active donor action is needed to increase organ donation from the potential deceased donors.

Keywords: Brain death, Tissue and organ procurement, Intensive care units, Neurosurgery

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Fig. 1.

Age and sex distribution.

Fig. 2.

Cause of patients who expired without organ donation in neurosurgical intensive care unit. Abbreviations: CVA, cerebral vascular accident; TA, traffic accident.