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Donation after Brain-Stem Death DBD

This session presents regional data on DBD and highlights the importance of neurological confirmation of death. It explores strategies to increase the quality of DBD organs and adopt care bundles for donor optimization. Collaboration in the Scout pilot Organ Donation program is discussed.

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Donation after Brain-Stem Death DBD

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  1. Donation after Brain-Stem DeathDBD Dr Farrel Igielman Dr Dale Gardiner Dr Gerlinde Mandersloot 4th June 2013

  2. 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

  3. LONDON Regional Data Dr Farrel Igielman Clinical Lead Organ Donation Queens and King George Hospitals

  4. Donation after Brain Death (DBD) Mechanically ventilated patient where death has been confirmed using neurological criteria. LONDON 93 donors (2012-2013) 14.8% increase (from 5 years ago) Lungs Heart Small Intestine Kidneys Liver Pancreas

  5. Donation in London 2003-2013 44.8% 14.8% 145.8% 5 Organ Donation Past, Present and Future

  6. Donation in London 2003-2013 6 Organ Donation Past, Present and Future

  7. best transplant outcome favours DCD DBD kidneys intestine lungs pancreas liver heart

  8. 100 87 86 80 82 78 76 76 76 76 74 74 74 73 60 ND tested (%) 40 20 0 North South South South South Eastern London Midlands Northern Scotland Yorkshire Northern East West West Wales Ireland Central Team -------- National rate DBD- Neurological death testing rate LONDON 3rd 1 April 2012 to 31 March 2013, data as at 4 April 2013 Organ Donation Past, Present and Future

  9. 100 16 5 19 30 13 23 20 29 3 22 28 8 17 80 24 10 12 11 15 2 18 4 60 7 ND tested (%) 9 27 21 40 1 20 0 14 6 25 26 0 10 20 30 40 50 60 Number of neurological death suspected patients Hospital National rate 95% Lower CL 95% Upper CL 99.8% Lower CL 99.8% Upper CL DBD- London Neurological death testing rate 1 April 2012 to 31 March 2013, data as at 4 April 2013 Organ Donation Past, Present and Future

  10. Mean no. of organs donated per donor LONDON Northern (1st) : Every 10 donors save 4 more lives than we do Tied 9’th 1 April 2012 to 31 March 2013, data as at 4 April 2013 Organ Donation Past, Present and Future

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