causes of death in deceased organ donors: changing profiles? g. kirste, f. schaub, cl...
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Causes of Death in Deceased Organ Donors: Changing Profiles?
G. Kirste, F. Schaub , CL Fischer-Fröhlich; Germany
ISODP 2011, Buenos Aires, Argentina
Causes of Death of Organ Donors
82 % Atraumatic causes of death
Killed in road traffic
2010: 3657 Verkehrstote
Reduced mortality after stroke
Age of Organ Donors in Germany
Variation in mortality according to cause of death due to:
• Epidemiological changes
• Stroke units
• New advanced treatment protocols for devastating cerebral lesions
• Proper care of vasospasm after subarachnoid hemorrhage (SAH)
Changes in the population of organ donors ?
Introduction:
All potential and eligible donors in Germany (2006-2010):
• Cause of death according to cerebral lesion causing admission reviewed (e.g. SAH -> vasospasm related stroke = SAH)
• Annual variation in cause of death analyzed (significance: p<0.05)
Potential Donors: 13.657
Eligible Donors: 9.440
Actual Donors: 6.355
Methods:
Results: Potential Donors (n=13657)
0
100
200
300
400
500
600
700
800
900
Hypoxia ICB SAH Trauma Ischemia Other
Cause of Death
Ca
se
s
20062007200820092010
Hypoxia=cererbral hypxoia, ICB=intracerebral bleeding, SAH=subarachnoid haemorrhage, Ischemia=ischemic stroke, Trauma=head trauma, Other=includes primary brain tumour, meningitis etc
p<0.04
p=0.002
p=0.086
p=0.056
ns
ns
ns
Donor age: 47±20 yrs. 63±15 yrs. 54±14 yrs. 46±22 yrs. 61±14 yrs. 41±21 yrs. p<0.001
Results: Eligible Donors (n=9440)
0
100
200
300
400
500
600
700
Hypoxia ICB SAH Trauma Ischemia Other
Cause of Death
Ca
se
s
20062007200820092010
Hypoxia=cererbral hypxoia, ICB=intracerebral bleeding, SAH=subarachnoid haemorrhage, Ischemia=ischemic stroke, Trauma=head trauma, Other=includes primary brain tumour, meningitis etc
p<0.001
p=0.0022
p=0.076
p=0.06
ns
ns
p=0.043
Donor age: 45±19 yrs. 61±15 yrs. 53±13 yrs. 44±21 yrs. 60±13 yrs. 40±19 yrs. p<0.001
Results: Actual Donors (n=6355)
0
50
100
150
200
250
300
350
400
450
Hypoxia ICB SAH Trauma Ischemia Other
Cause of Death
Ca
se
s
20062007200820092010
Hypoxia=cererbral hypxoia, ICB=intracerebral bleeding, SAH=subarachnoid haemorrhage, Ischemia=ischemic stroke, Trauma=head trauma, Other=includes primary brain tumour, meningitis etc
p<0.02
p=0.0098
p=0.069
ns
ns
ns
ns
Donor age: 44±19 yrs. 61±14 yrs. 53±13 yrs. 44±21 yrs. 60±13 yrs. 39±21 yrs. p<0.001
•Introducing new treatment protocols (stoke units) for particular cerebral lesions contributes to changes in donor populations.
• Number of donors with SAH decreased significantly.
• Number of cases with cerebral hypoxia increased.
Summary:
Thank you