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New Tool May Improve Organ Donation Rates

Study of comatose patients identifies four factors that predict likelihood of being a suitable donor

MONDAY, April 26 (HealthDay News) -- A new tool may help identify comatose patients with irreversible neurologic injury who are candidates for organ donation after cardiac death protocols, according to research published in the April 27 issue of Neurology.

Alan Yee, D.O., of the Mayo Clinic in Rochester, Minn., and colleagues retrospectively analyzed 149 comatose patients who underwent withdrawal of life-sustaining measures from 2002 to 2008 in a neurologic intensive care unit, including 75 who had cardiac arrest within 60 minutes.

The researchers identified four factors that make it more likely that a person with irreversible brain damage will be a candidate for organ donation: no corneal reflex, no cough reflex, no motor response or extensor motor response, and an oxygenation index greater than 4.2. Compared to patients with none of the factors, they found that patients with all four factors were 93 percent more likely to die within 60 minutes of withdrawal of life support, and that those with one of the four factors were 65 to 76 percent more likely to die within 60 minutes.

"Having a simple predictive tool pertinent to patients with critical brain disease would be valuable to consulting neurologists and neurointensivists who are frequently asked to prognosticate the time to death after withdrawal of life-sustaining measures in potential candidates for organ donation after cardiac death. The simple variables reported in this study may constitute the basis to develop such a predictive model that would need to be validated prospectively," the authors conclude.

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