Factors predicting the usefulness of deceased donors

Background: Preoperative management for deceased donation is important. Deceased donation can failed for several reasons. We analyzed the clinical data of deceased donation after consent for cadaveric donation to evaluate the reasons of failure of organ procurement.

Material and methods: We retrospectively reviewed the medical records of 112 deceased donors in a single institution between January 1998 and September 2012. There were no organs from cardiac death donors.

Results: Of 112 deceased donors, 51 (45.5%) were traumatic brain deaths and 33 (29.5%), nontraumatic brain hemorrhages. The overall mean age was 37.2 (±16.6) years with 35 (30.7%) of female gender. There were 15 (13.3%) donation failures for all organs. Significant factors for failure were histories of cardiopulmonary resuscitation (odds ratio [OR], 0.17; 95% confidence interval [CI], 0.05-0.58; P = .005), cardiac arrest (OR, 0.03; 95% CI, 0.006-0.14; P < .001), or acute renal failure (OR, 0.05; 95% CI, 0.006-0.42; P = .006). The nonsignificant factors included the time from intensive care unit to brain death (mean time, 105.1 ± 153.4); diabetes insipidus; hypotension despite inotrophic therapy, hypothermia (<35°C), arrhythmia, infection, metabolic acidosis, disseminated intravascular coagulopathy, and brain death cause.

Conclusions: Failure of deceased donation was associated with cardiac arrest while awaiting organ procurement and the presence of an history of cardiopulmonary resuscitation or presence of acute renal failure.