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eISSN 3022-7712

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Korean J Transplant 2020; 34(4): 219-230

Published online December 31, 2020

https://doi.org/10.4285/kjt.20.0040

© The Korean Society for Transplantation

Causes of donation failure and improvement measures analyzed based on data from domestic deceased donors in 2019

Won-Hyun Cho

Korea Organ Donation Agency, Seoul, Korea

Correspondence to: Won-Hyun Cho
Korea Organ Donation Agency, 36 Choongjung-ro 133-gil, Seodaemun-gu, Seoul 03741, Korea
Tel: +82-2-542-5632
Fax: +82-2-3447-5631
E-mail: wh51cho@gmail.com

Received: September 4, 2020; Revised: September 23, 2020; Accepted: October 12, 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In 2019, 1,630 organs were recovered from 450 brain death donors nationwide and were transplanted into 1,612 transplant recipients. However, considering that the number of potential brain-dead linked to the Korea Organ Donation Agency (KODA) information center was 2,484, only 18.1% of the linked brain-dead donated successfully. Of the 1,606 people who were available for family interviews, 67.0% refused to donate, so their cause analysis and countermeasures are needed. In particular, 203 reported cases died during the early period of donor evaluation, so we need a special concern on these cases. After consent, 67 cases failed to donate due to death or poor organ condition, and this raises the question of the possibility of shortening brain death management time. The average time interval from the first investigation to the completion of the second investigation (11.5 hours), until obtaining a flat electroencephalogram (5.3 hours) and conclusion of the brain death committee is 5.9 hours. Reducing unnecessary brain death management time is expected to improve the quality of organs and increase the number of organs to be recovered. Therefore, efforts to accurately identify and report potential brain death, and efforts to reduce the time spent in confirming brain death together with improving awareness of organ donation in people across the country are necessary to increase the number of deceased donors even in the current brain death management system. Implementation of donation after circulatory death for mortality case during the donor management is also urgent.

Keywords: Brain death, Donor, Donor screening, Deceased donor

HIGHLIGHTS
  • The consent rate of families is closely related to the national consensus on life sharing, education and publicity, and government policies to save end-stage failure patients using all possible donor resources.

  • The donor’s will or family’s intention to donate their loved one should be respected by successful organ recovering and transplantation.