Eun Woo Lee; Hye Yeon Jang; Sang Youb Han; Kum Hyun Han; Se Won Oh; Young-Nam Roh

doi:10.4285/jkstn.2017.31.1.43

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Lee, Jang, Han, Han, Oh, and Roh: Influencing Factors Affecting Successful Organ Donation and Families’ Consent to Donate after Drain Death

Original Article

J Korean Soc Transplant 2017;31(1):43-48.

Published online: 19 January 2017

DOI: https://doi.org/10.4285/jkstn.2017.31.1.43

Influencing Factors Affecting Successful Organ Donation and Families’ Consent to Donate after Drain Death

Eun Woo Lee, M.D.¹, Hye Yeon Jang, B.S.N.², Sang Youb Han, M.D.³, Kum Hyun Han, M.D.³, Se Won Oh, M.D.³, Young-Nam Roh, M.D.^1,

¹Department of Surgery, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea

²Transplantation Center, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea

³Department of Nephrology³, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea

Corresponding author: Young-Nam Roh Department of Surgery, Inje University Ilsan Paik Hospital, Inje University College of Medicine, 170 Juhwa-ro, Ilsanseo-gu, Goyang 10380, Korea Tel: 82-53-250-7324, Fax: 82-31-910-7786 E-mail: Ironman0913@hanmail.netc1-jkstn-31-43

Received 6 August 2016 Revised 2 January 2017 Accepted 2 January 2017

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:

This study was conducted to identify the factors influencing successful organ donation and families’ consent to donate after brain death.

Methods:

Medical records and data regarding organ donation counseling with the families of 107 brain-dead potential donors between September 2012 and March 2016 at a single tertiary medical center were retrospectively reviewed.

Results:

The final consent rate was 57.9% (62/107), and successful donation was performed in 40.2% (43/107) of cases. Univariate and multivariate analyses revealed that the independent factors associated with successful organ donation were age ＜60 years (odds ratio [OR], 3.384; 95% confidence interval [CI], 1.350 to 8.484; P=0.009), systolic blood pressure ≥90 mmHg (OR, 6.261; 95% CI, 1.418 to 27.653; P=0.015), and serum sodium level ≥150 mEq (OR, 4.215; 95% CI, 1.655 to 10.733; P=0.003). Family's consent to donate was significantly associated with head trauma (OR, 3.538; 95% CI, 1.104 to 11.334; P=0.033) and serum sodium level ≥150 mEq (OR, 3.392; 95% CI, 1.404 to 8.194; P=0.007).

Conclusions:

Successful organ donation was associated with patient age, systolic blood pressure and serum sodium level. Family's consent to donate was associated with head trauma and serum sodium level.

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Keywords: Tissue and organ procurement, Families’ consent, Brain dead donor

REFERENCES

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Table 1.

Clinical characteristics at the time of potential donor iden tification (n=107)

Variable	Value
Age (yr)
Mean±SD	49.5±15.7
Range	3∼83
≥60	24 (22.4)
＜60	83 (77.6)
Sex (male/female)	37 (34.6)/70 (65.4
Cause of brain death
Cerebrovascular accident
Hemorrhage	44 (41.1)
Infarct	5 (4.7)
Trauma-related
Head trauma	25 (23.4)
Hypoxic brain injury
Post-CPR	11 (10.3)
Hanging	9 (8.4)
Hypoxic, etc.	9 (8.4)
Etc.
Brain tumor	3 (2.8)
Ventriculitis	1 (0.9)
SBP (mmHg)
Mean±SD	113.6±23.7
Range	54∼171
＞90	90 (84.1)
≤90	17 (15.9)
MAP SBP (mmHg)
Mean±SD	83.8±17.6
Range	44∼139
＞60	96 (89.7)
≤60	11 (10.3)
Inotropics (yes/no)	93 (86.9)/14 (12.1
Central venous pressure (mmHg)
Mean±SD	4.2±2.0
Range	1∼12
4∼10	71 (66.4)
＜4 or ＞10	36 (33.6)
Ejection fraction (%)
Mean±SD	58.3±11.4
Range	18∼80
≥50	94 (87.9)
＜50	13 (12.1)
Arterial blood gas (pH)
Mean±SD	7.37±0.1
Range	6.90∼7.61
7.30∼7.45	55 (51.4)
＜7.30 or ＞7.45	52 (48.6)
PaO₂:FiO₂
Mean±SD	218.8±26.8
Range	90∼400
≥300	53 (49.5)
＜300	54 (50.5)
Blood glucose (mg/dL)
Mean±SD	193.9±88.9
Range	67∼542
≤150	41 (38.3)
＞150	66 (61.7)
Serum Na+ (mEq)
Mean±SD	150.3±9.8
Range	128∼170
≥150	57 (53.3)
＜150	50 (46.7)
Craniotomy (yes/no)	38 (36)/69 (65)
Coma therapy (yes/no)	40 (37.4)/67 (62.6)
Family relationship
Parent	21 (19.6)
Descendant	21 (19.6)
Spouse	60 (56.1)
Sibling	5 (4.7)
Time interval between counselling and final family decision (hr)
Mean±SD	16.5±43.1
Range	0∼283
＜48	92 (86.0)
≥48	15 (14.0)
Final decision about organ donation (consent/refuse)	62 (57.9)/45 (42.1)

Data are presented as number (%) unless otherwise indicated. Abbreviations: CPR, cardiopulmonary resuscitation; SBP, systolic blood pressure; MAP, mean arterial pressure; PaO₂, partial pressure of oxygen; FiO₂, fraction of inspired oxygen.

Table 2.

Factors affecting successful organ donation (univariate analysis)

Variable	Unsuccessful donation (n=64)	Successful donation (n=43)	P-value
Age ＜60 years	45 (70.3)	38 (88.4)	0.028^a
Female sex	40 (62.5)	30 (69.8)	0.438^a
Head trauma	10 (15.6)	15 (34.9)	0.021^a
Inotropics	56 (87.5)	37 (86.0)	0.827^a
SBP ＞90 mmHg	50 (78.1)	40 (93.0)	0.033^b
MAP ＞60 mmHg	55 (85.9)	41 (95.3)	0.193^b
Craniectomy	23 (35.9)	15 (34.9)	0.911^a
Central venous pressure 4∼10 mmHg	43 (67.2)	28 (65.1)	0.824^a
Ejection fraction ≥50%	54 (84.4)	40 (93.0)	0.235^b
Arterial blood gas pH 7.30∼7.45	39 (60.9)	26 (60.5)	0.961^a
PaO₂:FiO₂ ＞300	29 (45.3)	24 (55.8)	0.237^a
Blood glucose ＜150 mg/dL	25 (39.1)	16 (37.2)	0.847^a
Serum Na+ ≥150 mEq	27 (42.2)	30 (69.8)	0.005^a
Coma therapy	19 (29.7)	21 (48.8)	0.045^a
Parent as prior determiner	9 (14.1)	12 (27.9)	0.077^a
Time interval until decision 48 hours	8 (12.5)	7 (16.3)	0.581^a

Data are presented as number (%).

Abbreviations: SBP, systolic blood pressure; MAP, mean arterial pressure; PaO₂, partial pressure of oxygen; FiO₂, fraction of inspired oxygen.

^a Chi-square test;

^b Fisher exact test.

Table 3.

Factors affecting successful organ donation (multivariate analysis^a)

Variable	P-value	Odd ratio (95% CI)
Age ＜60 years	0.009	3.384 (1.350∼8.484)
Head trauma	0.066	2.736 (0.934∼8.012)
SBP ＞90 mmHg	0.015	6.261 (1.418∼27.653)
Serum Na+ ≥150 mEq	0.003	4.215 (1.655∼10.733)
Coma therapy	0.172	1.917 (0.754∼4.871)

Abbreviations: CI, confidence interval; SBP, systolic blood pressure.

^a Binary logistic regression model.

Table 4.

Factors affecting family's consent for organ donation

Variable	Univariate analysis		Multivariate analysis^a
Variable	P-value	P-value	Odd ratio (95% CI)
Female sex	0.025^b	0.258	1.725 (0.670∼4.439)
Head trauma	0.011^b	0.033	3.538 (1.104∼11.334)
Serum Na+ ≥150 mEq	0.002^b	0.007	3.392 (1.404∼8.194)
Coma therapy	0.018^b	0.150	1.983 (0.780∼5.040)
Ejection fraction ≥50%	0.041^c	0.468	0.584 (0.137∼2.499)

Abbreviation: CI, confidence interval.

^a Binary logistic regression model;

^b Chi-square test;

^c Fisher exact test.

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