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Lost potential of kidney and liver donors amongst deceased intracerebral hemorrhage patients.

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Title: Lost potential of kidney and liver donors amongst deceased intracerebral hemorrhage patients.
Authors: Sairanen, T., Koivisto, A., Koivusalo, A.‐M., Rantanen, K., Mustanoja, S., Meretoja, A., Putaala, J., Strbian, D., Kaste, M., Isoniemi, H., Tatlisumak, T.
Source: European Journal of Neurology. Jan2014, Vol. 21 Issue 1, p153-159. 7p.
Subjects: Intracerebral hematoma, Organ donation, Kidney transplantation, Liver transplantation, Hematoma
Abstract: Background and purpose Intracerebral hemorrhage ( ICH) has high acute mortality. The number of potential kidney and liver donors amongst deceased ICH patients was estimated to improve our institutional guidelines on acute care of neurocritical patients to increase organ donation. Methods A chart review was carried out by a multi-professional team for consecutive ICH patients admitted to the emergency department at Helsinki University Central Hospital and dying within 14 days between 2005 and 2010. Results In all, 955 patients had follow-up data, of whom 254 (27%) died within 14 days and eight ended up as organ donors. An additional 51 potentially suitable donors not different from actual donors were identified: nine suitable for kidney donation, 11 for liver and 31 for both. In 49/51 (96%) cases prognosis seemed non-existent and do-not-resuscitate orders were issued early, which led to refrainment from intensive care in 76.5%. These potential donors differed from those ICH patients surviving a whole year ( n = 529) by male preponderance, more severe symptoms (median National Institutes of Health Stroke Scale 25 vs. 6 and Glasgow Coma Scale 7 vs. 15), larger hematoma volumes of 24.8 cm3 (vs. 6.7), and frequent finding of midline shift and intraventricular rupture of the hemorrhage in admission brain CT. Based on the results, our guidelines were revised towards more active treatment including mechanical ventilation for neurocritical patients at the emergency department for at least 48 h, resulting in an increase in organ donations in 2012. Conclusions A considerable number of ICH patients are potential organ donors if the evaluation takes place on arrival and organ donation is considered as part of usual end-of-life care. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Lost potential of kidney and liver donors amongst deceased intracerebral hemorrhage patients.
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  Data: <searchLink fieldCode="AR" term="%22Sairanen%2C+T%2E%22">Sairanen, T.</searchLink><br /><searchLink fieldCode="AR" term="%22Koivisto%2C+A%2E%22">Koivisto, A.</searchLink><br /><searchLink fieldCode="AR" term="%22Koivusalo%2C+A%2E‐M%2E%22">Koivusalo, A.‐M.</searchLink><br /><searchLink fieldCode="AR" term="%22Rantanen%2C+K%2E%22">Rantanen, K.</searchLink><br /><searchLink fieldCode="AR" term="%22Mustanoja%2C+S%2E%22">Mustanoja, S.</searchLink><br /><searchLink fieldCode="AR" term="%22Meretoja%2C+A%2E%22">Meretoja, A.</searchLink><br /><searchLink fieldCode="AR" term="%22Putaala%2C+J%2E%22">Putaala, J.</searchLink><br /><searchLink fieldCode="AR" term="%22Strbian%2C+D%2E%22">Strbian, D.</searchLink><br /><searchLink fieldCode="AR" term="%22Kaste%2C+M%2E%22">Kaste, M.</searchLink><br /><searchLink fieldCode="AR" term="%22Isoniemi%2C+H%2E%22">Isoniemi, H.</searchLink><br /><searchLink fieldCode="AR" term="%22Tatlisumak%2C+T%2E%22">Tatlisumak, T.</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neurology%22">European Journal of Neurology</searchLink>. Jan2014, Vol. 21 Issue 1, p153-159. 7p.
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  Data: <searchLink fieldCode="DE" term="%22Intracerebral+hematoma%22">Intracerebral hematoma</searchLink><br /><searchLink fieldCode="DE" term="%22Organ+donation%22">Organ donation</searchLink><br /><searchLink fieldCode="DE" term="%22Kidney+transplantation%22">Kidney transplantation</searchLink><br /><searchLink fieldCode="DE" term="%22Liver+transplantation%22">Liver transplantation</searchLink><br /><searchLink fieldCode="DE" term="%22Hematoma%22">Hematoma</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Background and purpose Intracerebral hemorrhage ( ICH) has high acute mortality. The number of potential kidney and liver donors amongst deceased ICH patients was estimated to improve our institutional guidelines on acute care of neurocritical patients to increase organ donation. Methods A chart review was carried out by a multi-professional team for consecutive ICH patients admitted to the emergency department at Helsinki University Central Hospital and dying within 14 days between 2005 and 2010. Results In all, 955 patients had follow-up data, of whom 254 (27%) died within 14 days and eight ended up as organ donors. An additional 51 potentially suitable donors not different from actual donors were identified: nine suitable for kidney donation, 11 for liver and 31 for both. In 49/51 (96%) cases prognosis seemed non-existent and do-not-resuscitate orders were issued early, which led to refrainment from intensive care in 76.5%. These potential donors differed from those ICH patients surviving a whole year ( n = 529) by male preponderance, more severe symptoms (median National Institutes of Health Stroke Scale 25 vs. 6 and Glasgow Coma Scale 7 vs. 15), larger hematoma volumes of 24.8 cm3 (vs. 6.7), and frequent finding of midline shift and intraventricular rupture of the hemorrhage in admission brain CT. Based on the results, our guidelines were revised towards more active treatment including mechanical ventilation for neurocritical patients at the emergency department for at least 48 h, resulting in an increase in organ donations in 2012. Conclusions A considerable number of ICH patients are potential organ donors if the evaluation takes place on arrival and organ donation is considered as part of usual end-of-life care. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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