J Korean Soc Transplant.  2010 Sep;24(3):196-203. 10.4285/jkstn.2010.24.3.196.

Clinical Analysis of 10 Years Brain Death Donors in Single Center after Korean Network for Organ Sharing

• Lee JM
• Lee YJ
• Kyung KD
• Im YC
• Oh CK
• Ahn JH
• Min YG
• Kim JH
• Lee MY

• KMID: 1464313
• DOI: http://doi.org/10.4285/jkstn.2010.24.3.196

Abstract

BACKGROUND
Brain-death donation became legal in Korea after "The law of organ transplantation" was established at 2000. Therefore, in this study, we report on the clinical analysis of brain-death donors at Ajou University Hospital since the Korean Network for Organ Sharing (KONOS) was launched in the year 2000.
METHODS
We reviewed 90 brain-death donors who were managed at Ajou University Hospital from 2000 to 2009 and we retrospectively analyzed the clinical characteristics.
RESULTS
The number of brain-death donors was 29 from 2000 to 2005 and 61 from 2006 to 2009, and this showed an increasing tendency. Forty-three brain-death donors (47.8%) were detected at our hospital and 47 donors (52.2%) were from referring hospitals. The percent of brain-death donors at our hospital was 31.0% from 2000 to 2005 and 55.7% from 2006 to 2009 (P=0.042). The mean age of the brain-death donors was 36.3 years (range: 8 months~70 years) and the fifth decade was the most common (25.6%). The gender ratio showed significant difference (P=0.001); there were 60 male donors (66.7%) and there were 30 females (33.3%). The most common cause of brain-death was cerebrovascular disease/stroke (48 donors, 53.3%) followed by traffic accident (15 donors, 16.7%). The most common blood type was Rh+ O (35.6%). The mean number of harvested organs was 3.9 and one donor (1.1%) had the largest number of harvested organs (9) (liver, 2 kidneys, pancreas, heart, lung, 2 corneas, tissue). The mean time to procurement was 3.6 days (range: 2~24 days).
CONCLUSIONS
We recommend active discovery and evaluation of brain-death donors in all the hospitals including the hospital organ procurement organization (HOPO).

Keyword

Brain-death donor; Korean Network for Organ Sharing (KONOS); Activation of transplantation

MeSH Terms

Accidents, Traffic
Brain
Brain Death
Cornea
Female
Heart
Humans
Jurisprudence
Kidney
Korea
Lung
Male
Pancreas
Retrospective Studies
Tissue and Organ Procurement
Tissue Donors

Figure

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  Fig. 1. Distributions of brain death donors in inside and outside hospitals.

Reference

References

1). Zamperetti N, Bellomo R, Defanti CA, Latronico N. Irreversible apnoeic coma 35 years later. Towards a more rigorous definition of brain death? Intensive Care Med. 2004; 30:1715–22.

2). Beecher HK. Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain-Death. A definition of irreversible coma. Special communication: Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death. JAMA. 1968; 205:337–40.

3). Lee SB. Medical definition of death and progression of the hypothesis about the brain death. J Korean Med Assoc. 1999; 42:342–8. (이상복. 죽음에 관한 의학적 정의와 뇌사설의 전개과정. 대한의사협회지 1999;42: 342–8.).

4). Han SS, Kim JH, Hong HJ. A study on the organ transplantation according to the law of organs transplantation. J Korean Soc Transplant. 2003; 17:203–19. (한성숙, 김중호, 홍현자. 장기 등 이식에 관한 법률에 따른 장기이식 실태조사. 대한이식학회지 2003;17: 203–19.).

5). Choi KT, Lee YM, Seong KW, Lee C, Lee DM, Suh BT, et al. An analysis of the clinical status of the brain death donors. Korean J Anesthesiol. 1998; 34:160–6. (최규택, 이유미, 성규완, 이청, 이동명, 서병태, 등. 장기기증 뇌사자 분석. 대한마취과학회지 1998;34: 160–6.).

6). Ministry of Health and Welfare (MOHW). The laws of organs transplantation. [Internet]. Seoul: MOHW;2010. [cited 2010 April 1]. Available from:. http/www.mohw.go.kr.

7). Cho WH, Kim SI, Kim MS, Ahn C, Bang KT, Jeon KO, et al. A proposal to activate organ donation: report of organ allocation study group. J Korean Soc Transplant. 2009; 23:8–14. (조원현, 김순일, 김명수, 안규리, 방기태, 전경옥, 등. 국내 장기기증 활성화를 위한 방안: Organ Allocation 연구회 보고서. 대한이식학회지 2009;23: 8–14.).

8). Chung UK, Cho WH, Kim HT, Koo JH, Joo SH, Hwang EA, et al. Cadaveric renal transplantation, before and after 국립장기이식관리센터 System (single center report) J Korean Soc Transplant. 2004; 18:171–8. (정운경, 조원현, 김형태, 구자현, 주신헌, 황은아, 등. 국립장기이식관리센터 전후의 뇌사자 신이식의 변화양상(단일센터 성적). 대한이식학회지 2004;18: 171–8.).

9). Cho WH, Kim HT, Lee HJ, Seo YM, Lee SD, Son EI, et al. Development of Korean model for independent organ procurement organization. J Korean Soc Transplant. 2008; 22:109–19. (조원현, 김형태, 이현진, 서영민, 이상도, 손은익, 등. 지역 장기구득기관의 한국형 모델 개발. 대한이식학회지 2008;22: 109–19.).

10). Korean Network for Organ Sharing (국립장기이식관리센터). Statistics of organ transplantation [Internet]. Seoul: 국립장기이식관리센터;2009. [cited 2010 Apr 1]. Available from:. http://www.국립장기이식관리센터.go.kr.

11). Kwak JY. Special report: the law about the brain-death donation and organs transplantation. J Korean Soc Transplant. 2007; 21:1–3. (곽진영. 뇌사자 장기이식과 장기 등 이식에 관한 법률. 대한이식학회지 2007;21: 1–3.).

12). Lee YC, Huh KH, Kim HJ, Jeon KO, Kim SI, Kim YS, et al. Review of patients who underwent renal transplantation in China. J Korean Soc Transplant. 2004; 18:61–4. (이영찬, 허규하, 김현정, 전경옥, 김순일, 김유선, 등. 중국에서 신장이식수술을 받고 귀국한 환자의 문제점. 대한이식학회지 2004;18: 61–4.).

13). Ministry of Health and Welfare (MOHW) Blood and Organ Team. A comprehensive plan to improve for management of organ donation. Seoul: MOHW; 2005.10. (보건복지부 혈액장기팀. 장기기증관리개선 종합대책. 서울: 보건복지부: 보건복지부;2005. .10.).

14). Ahn SY. Status of organ donation in Korea and the role of 국립장기이식관리센터. Education about brain-death organ donation for nurses in the field of neuro and neurosurgery; 2007 June 27; Seoul, Korea. Seoul: Korean Network for Organ Sharing (국립장기이식관리센터);2007. p. 11–21. (안소영. 우리나라의 장기기증 현황 및 국립장기이식관리센터 역할. 전국 신경과 및 신경외과 간호사 뇌사자 장기기증 교육; 2007년 6월 27일; 서울, 대한민국. 서울: Korean Network for Organ Sharing (국립장기이식관리센터); 2007: 11–21.).

15). Gortmaker SL, Beasley BC, Brigham LE, Franz HG, Garrison RN, Lucas BA, et al. Organ donor potential and performance: size and nature of the organ shortfall. Crit Care Med. 1996; 24:432–9.

16). Madsen M, Bøgh L. Estimating the organ donor potential in Denmark: a prospective analysis of deaths in intensive care units in northern Denmark. Transplant Proc. 2005; 37:3258–9.

17). Lee SJ, Park JB, Lyo IU, Sim HB, Song SK, Kwon SC. The organ donation rates in the neurosurgical field: preliminary study in a single institute. J Korean Soc Transplant. 2009; 23:252–6. (이승진, 박준범, 여인욱, 심홍보, 송순경, 권순찬. 신경외과 영역에서 발생하는 장기 기증률: 단일병원에서의 예비연구. 대한이식학회지 2009;23: 252–6.).

18). Spanish National Transplant Organization (ONT) [Internet]. Asturias, Spain: ONT;2010. [cited 2010 April 5]. Available from:. http://www.ont.es/Paginas/default.aspx.

19). Philips MG. UNOS organ procurement. UNOS update. 1995. 11.

20). Wang Y, Levi CR, Attia JR, D'Este CA, Spratt N, Fisher J. Seasonal variation in stroke in the Hunter Region, Australia: a 5-year hospital-based study, 1995–2000. Stroke. 2003; 34:1144–50.

21). Haberman S, Capildeo R, Rose FC. The seasonal variation in mortality from cerebrovascular disease. J Neurol Sci. 1981; 52:25–36.

22). Gill JS, Davies P, Gill SK, Beevers DG. Wind-chill and the seasonal variation of cerebrovascular disease. J Clin Epidemiol. 1988; 41:225–30.

23). AlAttar B, Shaheen F, Salam MA, Al-Sayyari A, Babiker A, Zakaria H, et al. Implications of ICU stay after brain death: the Saudi experience. Exp Clin Transplant. 2006; 4:498–502.

24). Ha HS, Hong JJ, Kim SC, Lee SG, Song MG, Han DJ. Study on physician's perceptions and attitudes on organ donation in brain dead donors. J Korean Soc Transplant. 2001; 15:51–7. (하희선, 홍정자, 김송철, 이승규, 송명근, 한덕종. 뇌사자 장기기증에 대한 담당의사의 관심 및 태도 조사연구. 대한이식학회지 2001;15: 51–7.).

25). Lee WH, Moon OR, Kwak JY. A study on the analysis of relative factors of intensive care unit nurses attitude in brain death organ donation. J Korean Soc Transplant. 2001; 15:217–24. (이원희, 문옥륜, 곽진영. 뇌사자 장기기증에 관한 중환자실 간호사의 태도에 영향을 미치는 요인분석 연구. 대한이식학회지 2001;15: 217–24.).

26). Kang KJ, Kim SH. Nurse's knowledge and attitudes on organ donation in brain death. J Korean Soc Transplant. 2004; 18:81–6. (강경자, 김상희. 뇌사자 장기기증에 대한 간호사의 지식과 태도. 대한이식학회지 2004;18: 81–6.).