Improvement of the system for request for organ donation in brain death patients

sakuntala rodmai¹

¹co-ordination organ transplant, sunpasitthiprasong hospital, ubonratchatani, Thailand

Background : The system for request for organ donation in brain death patients has been in place since 2001. However, a significant number of relatives of brain death patients considered potential organ donors were not approached for request for organ donation. In 2001, only 13 from 94 brain death patients completed the organ donation. This may be due to hard workload of critical care units, which might in turns prevent them from timely notifying an organ donation unit concerning potential organ donors. We hypothesized that if potential candidates for organ donation were approached promptly, the number and successful rates of organ donation would be improved.

Objectives : To increase the rates of organ donation in brain death patients

Methods : Between October 2011 and September 2012, attempts to increase the number and rates of organ donation of brain death patients in the Sunpasitthiprasong Hospital, a 1,200-bed regional hospital, were taken. This included 1) improving the coordination of departments involved in organ donation procedures, 2) regular morning and afternoon nurse rounds to all critical care units, 3) prompt assessment of brain death patients and relevant laboratory test results, 4) provision of direct contact to responsible nurses in the organ donation unit, and

5) feedback of the results to stakeholders for further and continuous improvement. We compared the numbers and rates of organ donation before and after the implementation of the new system. 

Results: After the implementation of a new system for request for organ donation, the number of registered cases of brain deaths increased from 94 case in 2011 to 152 case in 2012. The rates of organ donation increased from 13.8% (13 out of 94 cases) to 23.7% (36 out of 152 cases) in 2011 and 2012, respectively.

Discussion: Improvement of the system for request for organ donation in brain death patients through fostering effective co-ordination and communication between departments and units involved leads to prompt negotiation with relatives about the possibility of organ donation and helps enhance the rates of organ donation. Further implication is to improve the methods to care for subjects with brain death.