This Article Résumé de cet Article Full Text Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Baker, A. Articles by Shepherd, J. Search for Related Content PubMed PubMed Citation Articles by Baker, A. Articles by Shepherd, J.

Number of deaths by neurological criteria, and organ and tissue donation rates at three critical care centres in Canada

[Le nombre de morts selon des critères neurologiques et les taux de dons d’organes et de tissus dans trois centres de soins intensifs au Canada]

Andrew Baker, MD FRCPC^*,, Stephen Beed, MD FRCPC, John Fenwick, MD FRCPC, Maria Kjerulf, RN^*, Hilda Bell, RN^||, Suzie Logier, RN and John Shepherd, MD FRCPC^**

^* From the Departments of Critical Care,
Anesthesia,
^|| Palliative Care Unit, St. Michael’s Hospital, Ontario, Toronto; the
Department of Anesthesia and Critical Care,Queen Elizabeth II Health Science Centre, Halifax, Nova Scotia; the
Program of Critical CareUniversity of British Columbia, British Columbia; and the
^** Medical Administration, Vancouver General Hospital, Vancouver, British Columbia, Canada.

Address correspondence to: Dr. Andrew Baker, St. Michael’s Hospital, Room 7086 Bond Wing, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada. Phone: 416-864-5510; Fax: 416-864-5512; E-mail: bakera{at}smh.toronto.on.ca

Purpose: Comparative organ donation rates are expressed per million population and by this measurement, Canada lags behind other countries. These estimates do not account for differing demographics and health patterns of populations which can result in different rates of death by neurological criteria and subsequent donation rates. We sought to measure directly the number of deaths by neurological criteria, the associated donation rates, and the reasons for the differences.

Methods: A prospective evaluation of deaths by neurological and cardiorespiratory criteria in the critical care areas of three major adult Canadian tertiary care centres over a seven month period was undertaken. Patients were assessed for eligibility for organ and tissue donation and ultimate disposition.

Results: Annualized rates of death by neurological criteria varied from 2.3%–7.5% (8.6–28 patients) of all deaths. Conversion to actual donors ranged from 20–86%, with family refusal rates accounting for most of this variation. There were only three cases of suspected death by neurological criteria where a complete examination was not performed.

Conclusions: There is substantial geographic variability in the rate of neurological death and actual organ donation rates in these Canadian tertiary care centres. These variations are principally related to regional differences in demographics of brain injury, referral patterns and donation consent rates, rather than lack of identification of potential donors.

This article has been cited by other articles:

				S. D. Shemie Brain arrest to neurological determination of death to organ utilization: the evolution of hospital-based organ donation strategies in Canada/De l'arret cerebral a la determination neurologique de la mort et a l'utilisation d'organes : l'evolution du don d'organes en milieu hospitalier au Canada. Can J Anesth, August 1, 2006; 53(8): 747 - 752. [Full Text] [PDF]