Procurement of organs in Sergipe and factors associated to conversion of potential donors

Abstract

proCurement of orGans in serGipe and faCtors assoCiated to ConVersion of potential donors (aBSTRaCT)*. DiSSERTaTioN. aRaCaJu, 2009.EMILIA CERVINO NOGUEIRA**Background: A disproportion exists between the number of patients in wait list for transplant and the organ procure-ment, that it can be related to possible flaws in the poten-tial donor’s identification. Purpose: To estimate the number of potential organ do-nors in Sergipe; to characterize the potential donors; to de-termine the frequency of donation and to know the factors associated to the no donation.Methods: Quantitative, descriptive and retrospective study using data collected from the medical records of patients up to 65 years old dead for traumatic brain injury, cerebrovascu-lar stroke and primary brain tumor in the years 2005 to 2007 in three hospitals of Aracaju. Results: Of 766 medical records analyzed, 257 had sugges-tive registration of brain death, being 148 with the Term of Declaration filled out. Eighty five percent of the potential donors were at the Public Hospital. The median age was 33 years; prevailing the male (71.6%), the victims of traumatic brain injury (59.5%), and that in Urgency Unit (35.8%) and In-tensive Therapy Unit (34.5%). Half of them presented signs of brain death in the first two days of hospitalization. Sixteen (10.8%) potential donors completed all the exams of the pro-tocol of brain death and 12 (8.1%) became effective donors, being the absence of the diagnosis of brain death the princi-pal cause of no donation. The time between the first registra-tion and the removal of the organs was inferior at 40 hours in 50% of the donors.Conclusion: The number of potential organ donors in Ser-gipe has been underestimated due to flaws in the diagnosis and in the notification, resulting in a low donation index. The rates of family refuse and irreversible cardiac arrest suggest the need of educational actions driven to the health profes-sionals and the society in general. Key words: brain death, organ procurement, organ donors, organ transplantation, medical records.