gms | German Medical Science

68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
7. Joint Meeting mit der Britischen Gesellschaft für Neurochirurgie (SBNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

14. - 17. Mai 2017, Magdeburg

Brain Death and Organ Donation in Patients Suffering from Aneurysmal Subarachnoid Hemorrhage

Meeting Abstract

  • Patrick Czorlich - Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Neurochirurgie, Hamburg, Deutschland
  • Thomas Sauvigny - Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Neurochirurgie, Hamburg, Deutschland
  • Gerold Söffker - Universitätsklinikum Hamburg-Eppendorf, Klinik für Intensivmedizin, Hamburg, Deutschland
  • Stefan Kluge - Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
  • Jörn Grensemann - Universtitätsklinikum Hamburg-Eppendorf, Klinik für Intensivmedizin, Hamburg, Deutschland
  • Manfred Westphal - Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Neurochirurgie, Hamburg, Deutschland
  • Nils Ole Schmidt - University hospital Hamburg-Eppendorf, Klinik und Poliklinik für Neurochirurgie, Neurosurgery, Hamburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.28.02

doi: 10.3205/17dgnc346, urn:nbn:de:0183-17dgnc3464

Veröffentlicht: 9. Juni 2017

© 2017 Czorlich et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: Aneurysmal subarachnoid hemorrhage (SAH) is a life threatening disease with a mortality rate of ~ 20%. In part of the deceased patients cause of death is an irreversible loss of brain functions also known as brain death which is a precondition for a possible organ donation in Germany. Aim of this study was to evaluate the rate of brain deaths as well as the rate of realized organ donation in a cohort of SAH patients (pts.). Additionally demographic and clinical parameters were examined to identify factors that affect the rate of organ donation.

Methods: We performed a retrospective analysis of a single-center cohort of SAH pts. in a 6 year period. The rates of brain death and realized organ donation were examined in relation to age, gender, initial Glasgow Coma Scale (GCS), Hunt & Hess, WFNS and Fisher grade, proof of rebleeding or intracerebral hemorrhage, localization and treatment of the aneurysm, initial signs of cerebral herniation, cardiopulmonary resuscitation and the duration of treatment on the intensive care unit (ICU). The level of significance was set to < 0.05.

Results: 403 SAH pts. in total were included in this study. The case fatality rate was 18.6% (75pts). Brain death was determined in 37 patients (49.3%) and organ donation was completed in 24 patients (32.0%). In 26 patients (34.7%) organ donation was declined either prior or post determination of the brain death. In accordance to the presumed patients´ will in 23 patients (30.7%) no further SAH or ICU specific treatment was performed. Due to medical contraindications an organ donation was impossible in 2 patients (2.7%). Determination of brain death was associated with an age of < 60 years (p=0.001), a lower GCS (p=0.045) and higher WFNS grade (p=0.018). All other evaluated factors had no impact on the rate of brain deaths. An organ donation was realized in of 11 of 12 men (91.7%) while organ donation was realized in just 52% of female patients (13 of 25 women; p=0.018). All other factors had no impact on the rate of organ donations.

Conclusion: We present one of the first reports dealing with the issue of brain death and organ donation in patients suffering from SAH with a rate of realized organ donation of 34.7% in all deceased patients. Further studies and efforts are necessary to improve this rate in Germany.