2013 - ISODP 2013 Congress


Oral Presentation 3 on DCD Programs 1

41.5 - The differences between donors after cardiac death and donors after brain death in 22 Victorian hospitals

Presenter: Hugh, Stephens, Melbourne, Australia
Authors: Hugh Stephens, David Pilcher, Helen Opdam, Gregory Snell, Jeffrey Rosenfeld


The differences between donors after cardiac death and donors after brain death in 22 Victorian hospitals

Hugh Stephens1, David Pilcher2, Helen Opdam3, Gregory Snell4, Jeffrey Rosenfeld5

1MBBS/PhD Candidate, Monash University / The Alfred Hospital, Melbourne, Australia, 2Department of Intensive Care, Alfred Hospital, Melbourne, Australia, 3DonateLife Victoria, Melbourne, Australia, 4AIRmed Lung Transplant Service, Alfred Hospital, Melbourne, Australia, 5Department of Surgery, Alfred Hospital, Melbourne, Australia

Background & Aim

Since 2008, donation after cardiac death (DCD) programs across Australia have been increasing the donor pool by providing an alternative pathway to donation after brain death (DBD) [1]. As yet, little research has been conducted comparing the characteristics of these two donor types.

Methods

We analysed data from the DonateLife Audit database for 22 Victorian hospitals from 1 January 2010 through 30 June 2012 (n=18,949 deaths) to compare characteristics between donor types using ANOVA testing.

Results

140 DBD and 51 DCD successful donors' data was analysed. There was no significant difference in the proportion of donors that were DCD compared to DBD across the 3 years studied (p=0.85). No significant difference was found in age (p=0.20), location of death (p=0.24), or patient and family wishes (p=0.88, p=0.16 respectively). More DCD donors were male (75% vs 54%, p=0.01). DCD donors were less likely to die from a neurological cause of death (p<0.01, although both DBD and DCD donors more commonly died of neurological causes), although for those with neurological causes of death, there was no significant difference between groups (p=0.16). DBD donors more commonly met the DonateLife trigger criteria on admission to the emergency department (32% vs 8%, p<0.01). While more DCD donors came from tertiary centres (where DCD is facilitated) compared to metropolitan, pediatric, private or regional hospitals, the difference was not significant (p=0.07).

Conclusions

DCD donors appear to have different characteristics to DBD donors, particularly regarding cause of death, meeting trigger criteria in emergency departments and being male.


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