A new method to increase brain dead potential donor detection rate

K. Najafizadeh¹, O. Ghobadi¹, M. Dargahi¹, M. Hazrati¹, M. Mazlum¹

¹Lung Transplantation Research Center, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran (Islamic Republic of)

Background: Brain dead potential donor detection which is one of the most important steps of organ donation process has 3 different methods: Administrative, Active, Passive. Active method has been known the best way for detecting all possible donors. Our OPU in Tehran covers 112 hospitals. Because it is not practical to have this much in-hospital coordinators, we designed a new project for detecting all possible donors.

Methods: 112 hospitals were divided to 4 groups according to the number of ICU beds and having the neurosurgery ward. 6 expert nurses were chosen as inspectors. Hospitals were screened by 3 complementary methods: PPDDP (Persian potential donor detection project), TDDP (Telephone donor detection project), HR (hospital reporting). A schedule was designed for detection according to the hospital group. Inspectors should visit the hospitals in specific times according to the schedule. Telephone detection had to cover the other times. Hospital report could be done in any time of the day. Special forms were designed for: 1-GCS 3 brain dead; 2- GCS 3, not brain dead;  3- GCS 4 and 5 and 4- unacceptable donors. Group 1 were followed by coordinators, group 2 and 3 were followed by TTDP group and group 4 were just recorded for statistics.

Findings: The rate of detection increased from 50 to 475 per month. Eight out of 40 group 2 and 12 out of 260 group 3 were brain dead in follow up and 6 and 8 were actual donors respectively. 12 out of 80 group 1 donated their organs.

Conclusion: In the OPUs with high number of hospital , PPDDP is an effective method to detect all possible donors. This study showed that close following the GCS 3 non brain dead and GCS 4, 5 cases are very important.

Keywords: Organ donation, brain death, brain dead donor, detection rate