Single versus dual brain death examination in donors does not influence the number of organs recovered or transplanted
Varelas PN, Brady P, Kananeh M, Louchart L, Mehta C, Schultz L, Abdelhak T, Mayer SA, and Rehman MF. Single versus dual brain death examination in donors does not influence the number of organs recovered or transplanted. Neurocritical Care 2017; 27(2):S57.
Introduction There are no data supporting better numbers or function of organs in donors after brain death (BD), if there is a shorter waiting period (as expected with single brain death exam [SBD] ) from the time that BD is declared to the time the patient arrives at the operating room (OR). Our goal was to find if the number of brain death exams, either SBD or dual (DBD), had any impact on the number of organs recovered and transplanted Methods We evaluated our hospital's BD registry between January 2006 and June 2017 regarding SBD or DBD and cross-matched our electronic medical records with the records of the local organ procurement organization Results Out of 251 BD declarations, 150 led to consent, of which 74 (49.3%) after SBD and 76 (50.7%) after DBD. There was a trend for longer consent to OR time for DBD (41.7 ± 20.1 hours vs 36.4 ± 13.7 for SBD, p=0.07). There was no difference in the number of organs recovered or transplanted based on the number of exams (4.0 ± 1.8 vs 3.7 ± 1.8 organs/patient recovered and 3.2 ± 2.0 vs 2.8 ± 1.9 transplanted for SBD vs DBD, respectively, p>0.05). There was a trend for more lungs to be transplanted after SBD exam (62% vs 44%, p=0.06), but this was not found with kidneys, heart, liver, pancreas or intestines. In multiple logistic regression models, adjusting for variables pertinent to each individual organ function (for example, BUN or creatinine level for kidneys, blood gases for lungs etc), the number of exams was not an independent predictor for successful transplantation Conclusions SBD exam led to similar numbers of organs transplanted compared to DBD exam in this single center registry analysis. More rapid brain death declaration, as with SBD, is not a factor that influences organ transplantation.