Issues in potential organ donor management

Organ transplantation continues to be hindered by a limited supply of organs. A significant percentage of potential organ donors are lost to medical failure or inability to obtain consent for donation. In a surgical ICU, physicians have refocused their efforts toward aggressive resuscitation, directed by control of coagulopathy and invasive monitoring and dedicated ICU management, while implementing a rapid brain death determination protocol. Over the past 6 years, length of stay until the legal determination of brain death is made has been shortened significantly, as have associated charges despite this more aggressive approach. As a result, physicians have eliminated medical failures before organ donation and have increased consent rates. They believe that the presented approach, if widely applied, potentially could improve the current organ supply shortage.