Korean J Transplant.  2023 Nov;37(Suppl 1):S99. 10.4285/ATW2023.F-6817.

Cases of inadequate donation in the operating room

• Lee M
• Choi J
• Kang H
• Lee J
• Moon I

• KMID: 2551686
• DOI: http://doi.org/10.4285/ATW2023.F-6817

Abstract

Background
We conducted a comparative analysis of cases of brain-dead donors who were not eligible for donation in the operating room (OR) in Korea for 10 years from 2013 to 2022. By analyzing these people, we try to seek measures for reducing inadequate donation cases and achieving successful donations.
Methods
Over the past 10 years from 2013 to 2022, managed donors were 5,020, of which 4,455 completed organ donation and 565 failed organ donations. Among them, a retrospective survey was conducted on 94 (17%) who were not suitable for organ donation in the OR.
Results
The average age was 57 years, and men were 63.8%, and women were 36.2%. The causes of brain death were cerebro-vascular/stroke 27.6%, hypoxic brain damage 38.2%, head trauma 32.9%, and other 1%. It took an average of 4.6 days for notifi-cation of potential brain-dead (PBD) from the day of hospital admission, and it took an average of 2.8 days to enter the OR from notification of PBD. The reasons for inadequate donations in the OR were poor organ condition 89.3%, death of the patient 2.1%, malignant tumor 7.5%, nontransplant recipients 1%.
Conclusions
Organ shortage is a serious problem and a problem that should be solved in every country around the world. Pro-fessional donor management is essential for the success of brain-dead organ donation, and the process of donation should be conducted instantly to reduce the cases of inadequate donation, considering the age, medical condition, and past medical history of brain-dead patients. To do this, education on the medical team and the establishment of donation consultation protocol are needed to explain the possibility of PBD, and donation of organs at early consultation to protectors, active treatment of brain-dead people is needed to maintain the donor's vital signs and optimal function of each organ. Since the brain death state is unstable, bedside examination are mainly performed, so there may be limitations in organ evaluation. The improvement of stability by supplementing evaluation of organ, and close discussion on suitable exam based on the donor’s condition are needed.