Organ Donation in Intensive Care Units of Hospitals in Warsaw

• Published in: Transplantation proceedings 2020-09, Vol.52 (7), p.2001-2006
• Main Authors: Karpeta, Edyta, Jóźwik, Agnieszka, Małkowski, Piotr, Kosieradzki, Maciej
• Format: Article
• Language: English
• Subjects: Adult; Brain Death; Female; Hospitals; Humans; Intensive Care Units - statistics & numerical data; Poland; Tissue and Organ Procurement - statistics & numerical data; Tissue and Organ Procurement - supply & distribution; Tissue Donors - statistics & numerical data; Tissue Donors - supply & distribution
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2020.02.096

In recent years a systematic decrease in donation activity in Poland (15.4 vs 13.0) has been observed. A significant reduction has been noticed in Warsaw (36.2 vs 19.2) as well. Data on deaths of patients admitted to intensive care units (ICUs) of Warsaw hospitals in from 2014 to 2018 were analyzed. Analysis was conducted in compliance with the Helsinki Congress and the Istanbul Declaration. Population of the city during this period averaged 1,753,480, although specialized capital hospitals service substantially bigger area than Warsaw alone. There are 18,500 to 18,600 deaths affecting this population every year. A total of 333 patients diagnosed as having brain death were included in analysis. In 42 cases (12.7%) data collection was given up because of lack of authorization. In all donors, death was diagnosed according to neurologic criteria. The most common causes were vascular brain diseases (64.1%) and craniocerebral trauma (21.4%). In 14.5% brain death occurred from other reasons. There are 20 hospitals with ICUs in Warsaw, which totals 318 intensive care beds. Program of identification of deceased organ donors was active in only 14 hospitals. A total of 243 potential donors (73%) were identified in the 3 most active hospitals. Analysis of ICU deaths of Warsaw hospitals showed a gradual decrease in the number of reported donors (from 75 in 2014 to 46 in 2018), although the number of all deaths did not decrease (the number of deaths in ICUs was on average 2.571/y). •The number of identified donors has systemically decreased over the past 5 years in intensive care units of Warsaw hospitals.•The percentage of family refusals and medical disqualifications has not increased. Hospitals with a similar profile differ in their transplantation activity.•The most active in the donation process are hospitals with intensive care units and neurology departments.•Pediatric hospitals have lower donation activity.