Fewer "Brain Deaths" and Donor Organs

Brain deaths fell in Canada and may have affected organ donation

(RxWiki News) Pinpointing the nature of serious brain injuries is key to those patients' care. Advances in treatment of these injuries may yield results for such patients. It also has consequences for other ailing people.

Canada has experienced a decrease in the number of injured patients being declared "brain dead," according to a new study.

As a result, the tally of vital organs procured from brain-injured persons for transplanting into people in need has also declined, the researchers concluded.

"Volunteer to be an organ donor."

Andreas Kramer, MD, of the Foothills Medical Centre at the University of Calgary in Alberta, Canada, was lead author of this study.

His research team analyzed health records of 2,788 patients who had been admitted to the hospital intensive care units in Calgary and later declared brain dead, a point when brain function has ended and cannot be reversed.

Based on their investigation, these researchers concluded that the odds of brain-injured patients being declared neurologically dead has steadily narrowed in recent years. The count of patients in that category went from 8.1 percent of all brain-injured persons in 2002 to 9.6 percent in 2004 to 2.2 percent in 2010, the researchers found.

The most dramatic decline in doctors' rulings of brain death occurred among people with traumatic brain injury. But also included, as examples, among those declared brain dead were persons who had bleeding in the brain or a lack of oxygen to the brain caused by stroke.

For individuals whose brains had such trauma and for their families, the decrease in the number of people being deemed brain dead is good news, the researchers wrote. Nevertheless, they added, organs procured from brain-dead Canadians have accounted for almost half of kidney transplants, 90 percent of lung and pancreas transplants and all heart and small bowel transplants, the researchers wrote.

"Our results likely help explain the relatively stagnant or even declining rates of deceased organ donation in some Canadian jurisdictions," they wrote. "That overall decline may reflect strides in preventing injury and in improving care for those with brain injuries. It also may be driving the decrease in organ donation in [certain] areas of the nation."

In light of that decline, more donations may need to come from patients who are alive and from the bodies of those who died of heart and circulatory diseases, the researchers wrote. Also, other "...innovations aimed at improving the use of donated organs" are needed, they wrote.

Improvements in emergency care given before brain-injured people actually reach a hospital and better care while hospitalized are contributing the new trend, the researchers wrote. Among other changes, Canada has created regional systems for managing care of the brain-injured and increased the number of surgeons and other specialists providing care for these kinds of patients.

Various efforts to reduce the number of traffic accidents and raise safety practiced during such recreation as skiing and cycling — including automobile air bags and safety helmets — also factor into the decline in deaths from brain injuries, the researchers wrote.

Deaths from injuries sustained in car wrecks fell 24 percent between 2006 and 2010, from 404 per year to 307 per year, the researchers wrote. This decrease in non-fatal collisions occurred even though Canada has experienced a net gain in population.

This study was published online October 28 in the Canadian Medical Association Journal.

These researchers did not report any financial investments or other involvement that might have shaped study design, outcomes or analysis.

Review Date: 
October 28, 2013