Causes of donation failure and improvement measures analyzed based on data from domestic deceased donors in 2019

In 2019, 1,630 organs were recovered from 450 brain death donors nationwide and were transplanted into 1,612 transplant recipients. However, considering that the number of potential brain-dead linked to the Korea Organ Donation Agency (KODA) information center was 2,484, only 18.1% of the linked brain-dead donated successfully. Of the 1,606 people who were available for family interviews, 67.0% refused to donate, so their cause analysis and countermeasures are needed. In particular, 203 reported cases died during the early period of donor evaluation, so we need a special concern on these cases. After consent, 67 cases failed to donate due to death or poor organ condition, and this raises the question of the possibility of shortening brain death management time. The average time interval from the first investigation to the completion of the second investigation (11.5 hours), until obtaining a flat electroencephalogram (5.3 hours) and conclusion of the brain death committee is 5.9 hours. Reducing unnecessary brain death management time is expected to improve the quality of organs and increase the number of organs to be recovered. Therefore, efforts to accurately identify and report potential brain death, and efforts to reduce the time spent in confirming brain death together with improving awareness of organ donation in people across the country are necessary to increase the number of deceased donors even in the current brain death management system. Implementation of donation after circulatory death for mortality case during the donor management is also urgent.