![POTENTIAL DBD DONOR A person w hose clinical condition is suspected to fulfill brain death criteria. ELIGIBLE DBD DONOR A medically suitable person who has been declared dead based on neurologic criteria as stipulated by the law of the relevant jurisdiction. Critical pathways for organ donation * POSSIBLE DECEASED ORGAN DONOR A patient with a devastating brain injury or lesion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Donation after BrainDeath ( DBD ) Treating physician to identify/refer a potential donor * The “dead donor rule” must be respected . That is, patients may only become donors after death, and the recovery of organs must not cause a donor’s death . ,[object Object],[object Object],[object Object],[object Object],[object Object],UTILIZED DBD DONOR An actual donor from whom at least one organ was transplanted. Donation after Circulatory Death ( DCD )](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
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Silent Brain Death Identification and Organ Donation
- 1. Silent Brain Death The problem of donor identification. F Procaccio , L Rizzato, A Ricci, A Nanni Costa Italian Transplant National Centre Rome - Italy ISODP - Buenos Aires 2011
- 4. Italian Regions – 2010 vs 2011 * preliminary data August 31, 2011 Declared BD p.m.p. 20 p.m.p. 80 p.m.p.
- 6. Indicators : Potential of donation Brain Death declarations PROC 2 = ------------------ % Deaths with Acute Cerebral Lesions in ICU Benchmarking 50-65 %
- 11. Utilized DBD Donors Age years Median Mean
- 12. Italian Registry – DACL in ICU Age Actual Donors Deaths with cerebral lesion Brain Deaths The “ silent ” BD vs Age F Procaccio et al. Transplant Proc, 2010
- 13. Deaths with ACL in ICU Age vs BD declaration vs Donors BD declared AGE DONORS
- 15. Deaths with ACL In ICU vs BD Declaration 391 DLCA 128 BDs 33% range 17/22 ( 77 %) 26/50 ( 52 %) 7/50 ( 14 %) Deaths With Acute Cerebral Lesion 4 ICUS around 50 5 ICUs 20-40 7 ICUs 1-10 16 ICUs Region x BD DACL DACL BD ICUs
- 17. ICU DDC The ICU Donation Champions & the Deceased Donor Coordination Tx Hospital
- 18. 2010
- 19. en sciene & en route Aggressive treatment circulation ventilation ICP control Max treatment Organs Brain All they need is flow recovery Brain Death Organ Donor
- 20. Transplant Proc, 2010 As neurointensive treatment can improve outcomes and reduce “silent” BDs, more DBD donors exist where patients with acute cerebral lesion are better treated.
- 21. Do enhance ICU’s SKills & Motivation Research Recognition in organ donation