Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Hepato-Pancreato-Biliary and Transplant Surgery, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Transpl Int. 2024 Aug 13;37:11903. doi: 10.3389/ti.2024.11903. eCollection 2024.
We aimed to assess the impact of hospital characteristics on the outcomes of detected possible brain-dead donors, in our organ procurement network in Iran. Data was collected through twice-daily calls with 57 hospitals' intensive care units and emergency departments over 1 year. The donation team got involved when there was suspicion of brain death before the hospital officially declared it. The data was categorized by hospital size, presence of neurosurgery/trauma departments, ownership, and referral site. Out of 813 possible donors, 315 were declared brain dead, and 203 were eligible for donation. After conducting family interviews (consent rate: 62.2%), 102 eligible donors became actual donors (conversion rate: 50.2%). While hospital ownership and the presence of trauma/neurosurgery care did not affect donation, early referral from the emergency department had a positive effect. Therefore, we strongly recommend prioritizing possible donor identification in emergency rooms and involving the organ donation team as early as possible. The use of twice-daily calls for donor identification likely contributed to the consistency in donation rates across hospitals, as this approach involves the donation team earlier and mitigates the impact of hospital characteristics. Early detection of possible donors from the emergency department is crucial in improving donation rates.
我们旨在评估医院特征对伊朗器官获取网络中检测到的可能脑死亡供体结局的影响。数据通过与 57 家医院的重症监护病房和急诊部门进行每日两次的电话沟通收集，持续了 1 年。当医院正式宣布脑死亡之前有脑死亡怀疑时，捐赠团队就会介入。数据按照医院规模、神经外科/创伤科的存在、所有权和转诊地点进行分类。在 813 名可能的供体中，有 315 名被宣布脑死亡，有 203 名符合捐赠条件。在进行家庭访谈（同意率：62.2%）后，有 102 名符合条件的供体成为实际供体（转化率：50.2%）。尽管医院所有权和创伤/神经外科护理的存在并未影响捐赠，但从急诊室的早期转诊则产生了积极影响。因此，我们强烈建议在急诊室优先确定可能的供体，并尽早让器官捐赠团队参与。每日两次的电话沟通用于确定供体，这可能有助于确保各医院的捐赠率保持一致，因为这种方法更早地涉及捐赠团队，并减轻了医院特征的影响。从急诊室早期发现可能的供体对于提高捐赠率至关重要。
