Abstract

Since 2010, the number of organ donations in Germany has decreased by one third, mostly due to undetected organ donors. It is unclear, how the undetected potential donor pool is distributed among the different German hospital categories (A = university hospital, B = hospitals with neurosurgery, C = hospitals without neurosurgery) and region types. We performed a nationwide secondary data analysis of all German inpatient cases of the year 2016 (n = 20,063,689). All fatalities were regarded as potential organ donors, in which primary or secondary brain damage was encoded and organ donation was not excluded by a contraindication or a lack of ventilation therapy. In 2016, 28,087 potential organ donors were identified. Thereof 21% were found in category A, 28% in category B and 42% in category C hospitals. The contact rate (= organ donation related contacts/ potential organ donors) and realization rate (= realized organ donations/ potential organ donors) of category A, B and C hospitals was 10.6% and 4.6%, 10.9% and 4.8% and 6.0% and 1.7%, respectively. 58.2% of the donor potential of category C hospitals was found in the largest quartile of category C hospitals. 51% (n = 14,436) of the potential organ donors were treated in hospitals in agglomeration areas, 28% (n = 7,909) in urban areas and 21% (n = 5,742) in rural areas. The contact- and realization rate did not significantly differ between these areas. The largest proportion of potential organ donors and the lowest realization rate are found in category C hospitals. Reporting and donation practice do not differ between urban and rural regions.

Highlights

  • Since 2010, the number of organ donations in Germany has decreased by one third

  • How the undetected potential donor pool is distributed among the different German hospital categories (A = university hospital, B = hospitals with neurosurgery, C = hospitals without neurosurgery) and region types

  • Thereof 21% were found in category A, 28% in category B and 42% in category C hospitals

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Summary

Introduction

Since 2010, the number of organ donations in Germany has decreased by one third. This development reached its peak in 2017 when 797 organ donors faced 9,697 patients waiting for a life-saving organ transplant [1]. An increase in organ donation numbers would significantly improve the quality of life [2] and life expectancy of thousands of people [1]. This described decline is mostly due to a reduction of deceased organ donations. In 2012 it became known that some doctors had falsified their patients’ data in a few cases in order to raise their rank on the waiting list This organ allocation scandal is regarded by many as the main reason for the declining organ donation numbers.

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