Research Article
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Year 2023, Volume: 9 Issue: 3, 574 - 581, 04.05.2023
https://doi.org/10.18621/eurj.1225842

Abstract

References

  • 1. Loupy A, Aubert O, Reese PP, Bastien O, Bayer F, Jacquelinet C. Organ procurement and transplantation during the COVID-19 pandemic. Lancet 2020;395:e95-6.
  • 2. Spears W, Mian A, Greer D. Brain death: a clinical overview. J Intensive Care 2022;10:16.
  • 3. Wijdicks EF, Varelas PN, Gronseth GS, Greer DM. Evidence-based guideline update: determining brain death in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2010;74:1911-8.
  • 4. Meyfroidt G, Gunst J, Martin-Loeches I, Smith M, Robba C, Taccone FS, et al. Management of the brain-dead donor in the ICU: general and specific therapy to improve transplantable organ quality. Intensive Care Med 2019;45:343-53.
  • 5. Park J, Yang NR, Lee YJ, Hong KS. A single-center experience with an intensivist-led brain-dead donor management program. Ann Transplant 2018;23:828-35.
  • 6. Chavali S, Rath GP, Sengupta D, Dube SK. Brain death diagnosis for potential organ donors during the Covid-19 pandemic. Neurol India 2021;69:995-6.
  • 7. Mengi T, Şirin H, Yaka E, Özdemir AÖ, Arsava EM, Topçuoğlu MA. Brain death diagnosis and management in the pandemic: expert opinion of the Turkish Neurological Society Neurological Intensive Care Scientific Working Group. Turk J Neurol 2021;27:1-4.
  • 8. Republic of Turkey Ministry of Health. Tissue OTaDSDaDSRoTMoHT, Organ Transplantation and Dialysis Services. Donations and Donors. Available at:https://organkds.saglik.gov.tr/dss/PUBLIC/Brain_Death.aspx. Accessed November 13, 2022.
  • 9. Valdes E, Agarwal S, Carroll E, Kvernland A, Bondi S, Snyder T, et al. Special considerations in the assessment of catastrophic brain injury and determination of brain death in patients with SARS-CoV-2. J Neurol Sci 2020;417:117087.
  • 10. Katvan E, Cohen J, Ashkenazi T. Organ donation in the time of COVID-19: the Israeli experience one year into the pandemic-ethical and policy implications. Isr J Health Policy Res 2022;11:6.
  • 11. Han SY, Kim JI, Lee EW, Jang HY, Han KH, Oh SW, et al. Factors associated with a family's delay of decision for organ donation after brain death. Ann Transplant 2017;22:17-23.
  • 12. Gortmaker SL, Beasley CL, Sheehy E, Lucas BA, Brigham LE, Grenvik A, et al. Improving the request process to increase family consent for organ donation. J Transpl Coord 1998;8:210-7.
  • 13. Hulme W, Allen J, Manara AR, Murphy PG, Gardiner D, Poppitt E. Factors influencing the family consent rate for organ donation in the UK. Anaesthesia 2016;71:1053-63.
  • 14. Shah MB, Lynch RJ, El‐Haddad H, Doby B, Brockmeier D, Goldberg DS. Utilization of deceased donors during a pandemic: argument against using SARS‐CoV‐2–positive donors. Am J Transplant 2020;20:1795-9.
  • 15. Kates OS, Fisher CE, Rakita RM, Reyes JD, Limaye AP. Use of SARS‐CoV‐2‐infected deceased organ donors: Should we always “just say no?”. Am J Transplant 2020;20:1787-94.
  • 16. Escudero D, Valentín MO, Escalante JL, Sanmartín A, Perez-Basterrechea M, de Gea J, et al. Intensive care practices in brain death diagnosis and organ donation. Anaesthesia 2015;70:1130-9.
  • 17. Çalışkan G, Sayan A, Kilic I, Haki C, Kelebek Girgin N. Has the COVID-19 pandemic affected brain death notifications and organ donation time? Exp Clin Transplant 2021 Aug 9. doi: . 10.6002/ect.2021.0090.
  • 18. Dal HC. Brain death and organ donation during the COVID-19 pandemic: a retrospective observational study. Çukurova Anestezi ve Cerrahi Bilimler Dergisi 2022;5:33-42.
  • 19. Ahmed O, Brockmeier D, Lee K, Chapman WC, Doyle MBM. Organ donation during the COVID-19 pandemic. Am J Transplant 2020;20:3081-8.
  • 20. Kirakli C, Uçar Z, Anil A, Ozbek I. [The effect of shortening confirmed brain death diagnosis time on organ donation rates in the intensive care unit]. Dahili ve Cerrahi Bilimler Yoğun Bakım Dergisi 2011;2:8-11. [Article in Turkish]
  • 21. Lustbader D, O'Hara D, Wijdicks E, MacLean L, Tajik W, Ying A, et al. Second brain death examination may negatively affect organ donation. Neurology 2011;76:119-24.
  • 22. Balkaya AN, Demirel A, Korkmaz HA, Özyaprak B, Kılıçarslan N, Yılmaz C. Brain death diagnosis and management in the COVID-19 pandemic. Cukurova Med J 2022;47:942-9.

Evaluation of organ donation process and affecting factors in COVID-19 pandemic

Year 2023, Volume: 9 Issue: 3, 574 - 581, 04.05.2023
https://doi.org/10.18621/eurj.1225842

Abstract

Objectives: More than six million people worldwide are affected by end-stage organ failure and the COVID-19 pandemic has dramatically changed organ and tissue donation.

Methods: The data of patients diagnosed with brain death between July 2018-March 2020 (pre-pandemic period) and April 2020-December 2021 (pandemic period) were analyzed retrospectively. Donor characteristics, laboratory levels, time from intensive care admission to determination of brain death, time to family approval, family approval rates and organ types were analyzed.

Results: The mean age of 56 patients with pre-pandemic diagnosis of brain death was 61.82 ± 21.39 years, 37 (63%) patients were donors and 53 organs were obtained. Mean age of 39 patients diagnosed with brain death during the pandemic was 58.26 ± 18.02 years and 38 organs were obtained from 21 (52.5%) donors. Between the two periods, there was a decrease of 30.35% in the diagnosis of brain death, 43.24% in the number of donors and 26.41% in the number of organs supplied. The most common cause of brain death was intracranial hemorrhage during both periods. While the time elapsed between family interview and surgery was 9.33 ± 2.19 hours before the pandemic, it was 15.29 ± 4.28 hours during the pandemic period (p = 0.01). There was a significant difference between C-reactive protein levels at the time of diagnosis of brain death (p < 0.05). Staphylococcus haemolyticus was most frequently seen in blood culture.

Conclusions: Brain death and organ donation have decreased significantly during the pandemic period compared to previous years, similar to research conducted in different countries and regions. Due to COVID-19, prolonged stays in the intensive care unit (ICU) may pose a risk of infection in ICU donors, and care should be taken in terms of donor loss.

References

  • 1. Loupy A, Aubert O, Reese PP, Bastien O, Bayer F, Jacquelinet C. Organ procurement and transplantation during the COVID-19 pandemic. Lancet 2020;395:e95-6.
  • 2. Spears W, Mian A, Greer D. Brain death: a clinical overview. J Intensive Care 2022;10:16.
  • 3. Wijdicks EF, Varelas PN, Gronseth GS, Greer DM. Evidence-based guideline update: determining brain death in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2010;74:1911-8.
  • 4. Meyfroidt G, Gunst J, Martin-Loeches I, Smith M, Robba C, Taccone FS, et al. Management of the brain-dead donor in the ICU: general and specific therapy to improve transplantable organ quality. Intensive Care Med 2019;45:343-53.
  • 5. Park J, Yang NR, Lee YJ, Hong KS. A single-center experience with an intensivist-led brain-dead donor management program. Ann Transplant 2018;23:828-35.
  • 6. Chavali S, Rath GP, Sengupta D, Dube SK. Brain death diagnosis for potential organ donors during the Covid-19 pandemic. Neurol India 2021;69:995-6.
  • 7. Mengi T, Şirin H, Yaka E, Özdemir AÖ, Arsava EM, Topçuoğlu MA. Brain death diagnosis and management in the pandemic: expert opinion of the Turkish Neurological Society Neurological Intensive Care Scientific Working Group. Turk J Neurol 2021;27:1-4.
  • 8. Republic of Turkey Ministry of Health. Tissue OTaDSDaDSRoTMoHT, Organ Transplantation and Dialysis Services. Donations and Donors. Available at:https://organkds.saglik.gov.tr/dss/PUBLIC/Brain_Death.aspx. Accessed November 13, 2022.
  • 9. Valdes E, Agarwal S, Carroll E, Kvernland A, Bondi S, Snyder T, et al. Special considerations in the assessment of catastrophic brain injury and determination of brain death in patients with SARS-CoV-2. J Neurol Sci 2020;417:117087.
  • 10. Katvan E, Cohen J, Ashkenazi T. Organ donation in the time of COVID-19: the Israeli experience one year into the pandemic-ethical and policy implications. Isr J Health Policy Res 2022;11:6.
  • 11. Han SY, Kim JI, Lee EW, Jang HY, Han KH, Oh SW, et al. Factors associated with a family's delay of decision for organ donation after brain death. Ann Transplant 2017;22:17-23.
  • 12. Gortmaker SL, Beasley CL, Sheehy E, Lucas BA, Brigham LE, Grenvik A, et al. Improving the request process to increase family consent for organ donation. J Transpl Coord 1998;8:210-7.
  • 13. Hulme W, Allen J, Manara AR, Murphy PG, Gardiner D, Poppitt E. Factors influencing the family consent rate for organ donation in the UK. Anaesthesia 2016;71:1053-63.
  • 14. Shah MB, Lynch RJ, El‐Haddad H, Doby B, Brockmeier D, Goldberg DS. Utilization of deceased donors during a pandemic: argument against using SARS‐CoV‐2–positive donors. Am J Transplant 2020;20:1795-9.
  • 15. Kates OS, Fisher CE, Rakita RM, Reyes JD, Limaye AP. Use of SARS‐CoV‐2‐infected deceased organ donors: Should we always “just say no?”. Am J Transplant 2020;20:1787-94.
  • 16. Escudero D, Valentín MO, Escalante JL, Sanmartín A, Perez-Basterrechea M, de Gea J, et al. Intensive care practices in brain death diagnosis and organ donation. Anaesthesia 2015;70:1130-9.
  • 17. Çalışkan G, Sayan A, Kilic I, Haki C, Kelebek Girgin N. Has the COVID-19 pandemic affected brain death notifications and organ donation time? Exp Clin Transplant 2021 Aug 9. doi: . 10.6002/ect.2021.0090.
  • 18. Dal HC. Brain death and organ donation during the COVID-19 pandemic: a retrospective observational study. Çukurova Anestezi ve Cerrahi Bilimler Dergisi 2022;5:33-42.
  • 19. Ahmed O, Brockmeier D, Lee K, Chapman WC, Doyle MBM. Organ donation during the COVID-19 pandemic. Am J Transplant 2020;20:3081-8.
  • 20. Kirakli C, Uçar Z, Anil A, Ozbek I. [The effect of shortening confirmed brain death diagnosis time on organ donation rates in the intensive care unit]. Dahili ve Cerrahi Bilimler Yoğun Bakım Dergisi 2011;2:8-11. [Article in Turkish]
  • 21. Lustbader D, O'Hara D, Wijdicks E, MacLean L, Tajik W, Ying A, et al. Second brain death examination may negatively affect organ donation. Neurology 2011;76:119-24.
  • 22. Balkaya AN, Demirel A, Korkmaz HA, Özyaprak B, Kılıçarslan N, Yılmaz C. Brain death diagnosis and management in the COVID-19 pandemic. Cukurova Med J 2022;47:942-9.
There are 22 citations in total.

Details

Primary Language English
Subjects Intensive Care
Journal Section Original Articles
Authors

Gökhan Kılınç 0000-0001-7979-6993

Fuat Çöken 0000-0002-7793-9230

Publication Date May 4, 2023
Submission Date December 28, 2022
Acceptance Date January 26, 2023
Published in Issue Year 2023 Volume: 9 Issue: 3

Cite

AMA Kılınç G, Çöken F. Evaluation of organ donation process and affecting factors in COVID-19 pandemic. Eur Res J. May 2023;9(3):574-581. doi:10.18621/eurj.1225842

e-ISSN: 2149-3189 


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