Donation after Brain-Stem Death
DBD
Dr Ranjit Dulai
Dr Dale Gardiner
Dr Gerlinde Mandersloot
26th June 2013
Organ Donation Past, Present and Future
Session Objectives
• Present regional data for DBD
• Understand that DBD gives better organs than DCD
• Increase rate of neurological confirmation of death
by increasing confidence in the Diagnosis of Death
• Increase quality of DBD organs
– adoption of extended care bundle and compliance
with the six early interventions in donor
optimisation
– collaboration in Scout pilot
Organ Donation Past, Present and Future
2
Regional Data
Dr Ranjit Dulai
East Kent Hospitals, CLOD
SOUTH EAST
Organ Donation Past, Present and Future
3
Donation after Brain Death
(DBD)
Mechanically ventilated patient
where death has been confirmed
using neurological criteria.
61 donors
(2012-2013)
8.9% increase
(from 5 years ago)
Lungs
Heart
Small Intestine
Kidneys
Liver
Pancreas
Organ Donation Past, Present and Future
SOUTH EAST
Donation in the South East Team
SOUTH EAST
2003-2013
100
19.7%
90
80
70
60
Total Deceased
Donation
Donation after Brain
Death
Donation after
Circulatory Death
8.9%
50
40
30
50.0%
20
10
Organ Donation Past, Present and Future
/1
3
20
12
12
11
/
20
20
10
/1
1
/1
0
20
09
/0
9
20
08
/0
8
20
07
/0
7
20
06
/0
6
20
05
/0
5
04
20
20
03
/0
4
0
5
Donation in the South East Team
SOUTH EAST
2003-2013
100
90
80
70
60
Donation after Brain
Death
50
40
30
20
10
Organ Donation Past, Present and Future
/1
3
20
12
12
11
/
20
20
10
/1
1
/1
0
20
09
/0
9
20
08
/0
8
20
07
/0
7
20
06
/0
6
20
05
/0
5
04
20
20
03
/0
4
0
6
best transplant outcome favours
DCD
DBD
kidneys
intestine
lungs
pancreas
liver
Organ Donation Past, Present and Future
heart
South East Neurological death testing rate
SOUTH EAST
100
ND tested (%)
80
87
5th
86
82
76
78
74
73
76
76
74
76
74
60
40
20
0
Team
-------- National rate
1 April 2012 to 31 March 2013, data as at 4 April 2013
Organ Donation Past, Present and Future
8
South East Neurological death testing rate
100
5 2723
1921
11 2
ND tested (%)
80
24
15
8
4
1
25
9
12
14
28
16
20
22
7
60
SOUTH EAST
3
26
6
40
13
18
20
0
10
17
0
5
10
15
20
25
30
35
40
45
50
55
Number of neurological death suspected patients
Hospital
95% Upper CL
National rate
99.8% Lower CL
95% Lower CL
99.8% Upper CL
1 April 2012 to 31 March 2013, data as at 4 April 2013
Organ Donation Past, Present and Future
9
Mean no. of organs donated per DBD donor
SOUTH EAST
Northern (1st) : Every 10 donors
save 2 more lives than we do
4.3
4.2
4.1
4.0
3.9
3.8
3.7
3.6
3.5
3.4
3.3
1 April 2012 to 31 March 2013, data as at 4 April 2013
Organ Donation Past, Present and Future
10