Brain stem death and organ donationÐ11 years on

Background. We studied previously patterns of organ donation in a teaching hospital. Eleven years later we repeated the study to investigate how patterns had changed. We also wanted to see whether non-heart beating donation was being practised in our intensive care units. Methods. All deaths were prospectively audited to identify potential heart beating and non-heart beating organ donors. The actual organ donors and reasons for not donating were identi®ed. Results. Overall, there was a signi®cant reduction in the number of potential organ donors in the 11-yr period. This was accompanied by an increase in refusal rates by relatives from 10 to 29%, and a decrease in refusal rates by the coroner from 28 to 11%. Conclusions. In this hospital the number of potential and actual organ donors has fallen in 11 yr. This is a combination of decreasing numbers of patients becoming brain dead and increased relative refusal rate. It has only been partially offset by a more liberal attitude of the coroner and non-heart beating donors