Solid organ transplantation is the treatment of choice for end stage organ failure to improve patients' quality of life and survival. Each year, more than 5,000 solid organ transplants are performed in France, mainly from brain death donors (BDD).
Approximately 1,500 BDD donors have one or more organs removed each year. Despite the growing demand for transplanted organs, the number of organs available from deceased donors has remained stable over the past few decades. This highlights the need to optimize the management of potential BDD, in order to increase both the quality and number of transplanted organs. Several studies have found an association between the characteristics and management of BDD donors and the number of organs, or even the function of transplanted organs. Data suggest that hemodynamic, respiratory, and metabolic therapeutic targets during BDD management prior to multi-organ procurement were associated with a higher number of transplanted organs compared to standard care. However, this has never been confirmed in a French population. Furthermore, while the impact of these therapeutic goals has been studied after the donor is in a state of brain death, the events occurring in the ICU before reaching brain death status and their impact on the number of organs retrieved have not been investigated. Lastly, the intensity of the therapeutic interventions used to achieve these goals, and certain management delays, have only been partially studied.
Our hypothesis is that achieving a bundle of therapeutic goals, and the intensity of the interventions used to reach these goals, both before and after BDD, are associated with a greater number of organs retrieved.
Patients over 18 years of age, hospitalized in the ICU
In a state of brain death
No objection to organ donation during their lifetime
Patients with social security coverage
Objection to the use of their data during their lifetime
Registration in the national refusal registry
Patients in a state of brain dead. Patients meeting the inclusion criteria from January 1, 2022, to December 31, 2024, will be included in the study.
Cohort
Retrospective
No interventtion
Other interventionto enhance the understanding of the factors associated with the number of organs retrieved from patients admitted to the ICU for organ donation
Mean arterial pressure
Mean arterial pressure (MAP) between 60 and 110 mmHg
Central venous pressure
Central venous pressure (CVP) between 4 and 12 mmHg
Left ventricular ejection fraction
Left ventricular ejection fraction (LVEF) ≥ 50%
vasopressor
Low doses and a single vasopressor. (≤10 µg/kg/min of dopamine or ≤60 µg/min of Neosynephrine or ≤10 µg/min of norepinephrine))
demographics of Brain dead
The demographics of Brain dead
Causes of neurological injury leading to brain death
Describe the causes of neurological injury leading to brain death
Timelines and durations of patient management before and after brain death
Descibe the timelines and durations of patient management before and after brain death
Incidence of organ failures before and after brain death
Describe the incidence of organ failures before and after brain death
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