Purpose: It is desirable to identify a potential organ donor (POD) as early as possible to achieve a donor conversion rate (DCR) as high as possible which is defined as the actual number of organ donors divided by the number of patients who are regarded as a potential organ donor. The DCR is calculated with different assessment tools to identify a POD. Obviously, with different assessment tools, one may calculate different DCRs, which make comparison difficult. Our aim was to determine which assessment tool can be used for a realistic estimation of a POD pool and how they compare to each other with regard to DCR. Methods: Retrospective chart review of patients diagnosed with a subarachnoid haemorrhage, traumatic brain injury or intracerebral haemorrhage. We applied three different assessment tools on this cohort of patients. Results: We identified a cohort of 564 patients diagnosed with a subarachnoid haemorrhage, traumatic brain injury or intracerebral haemorrhage of whom 179/564 (31.7%) died. After applying the three different assessment tools the number of patients, before exclusion of medical reasons or age, was 76 for the IBD-FOUR definition, 104 patients for the IBD-GCS definition and 107 patients based on the OPTN definition of imminent neurological death. We noted the highest DCR (36.5%) in the IBD-FOUR definition. Conclusion: The definition of imminent brain death based on the FOUR-score is the most practical tool to identify patients with a realistic chance to become brain dead and therefore to identify the patients most likely to become POD.

Brain death, Critical care organisation, Ethics, Neurotrauma, Stroke, Transplantation
dx.doi.org/10.1007/s00134-011-2131-6, hdl.handle.net/1765/26016
Intensive Care Medicine
Erasmus MC: University Medical Center Rotterdam

de Groot, Y.J, Wijdicks, E.F.M, van der Jagt, M, Bakker, J, Roozenbeek, B, IJzermans, J.N.M, & Kompanje, E.J.O. (2011). Donor conversion rates depend on the assessment tools used in the evaluation of potential organ donors. Intensive Care Medicine, 37(4), 665–670. doi:10.1007/s00134-011-2131-6