Dr. Brown is supported by an NINDS Career Development Award (K23 NS051202). The other authors declare no conflicts of interest or financial disclosures.
Lack of association between decompressive craniectomy and conversion to donor status
Article first published online: 18 JUL 2010
© 2010 John Wiley & Sons A/S
Volume 25, Issue 1, pages 83–89, January/February 2011
How to Cite
Fletcher, J. J., Bergman, K., Watcharotone, K., Jacobs, T. L. and Brown, D. L. (2011), Lack of association between decompressive craniectomy and conversion to donor status. Clinical Transplantation, 25: 83–89. doi: 10.1111/j.1399-0012.2010.01320.x
- Issue published online: 7 FEB 2011
- Article first published online: 18 JUL 2010
- Accepted for publication 15 June 2010
- deceased donor;
- decompressive craniectomy;
- donation after cardiac death;
- organ donation;
- solid organ transplant
Fletcher JJ, Bergman K, Watcharotone K, Jacobs TL, Brown DL. Lack of association between decompressive craniectomy and conversion to donor status. Clin Transplant 2011: 25: 83–89. © 2010 John Wiley & Sons A/S.
Abstract: There has been a recent resurgence in the use of decompressive craniectomy (DC) following severe brain injury. The aim of this study was to evaluate any association between DC and solid organ donation. We performed a retrospective, single-center, cohort study involving referrals to the local organ procurement organization, excluding those with anoxic brain injury. Of subjects referred, 64 (53%) were deemed eligible for donation and 29 (24%) converted to donor status. DC was performed with similar frequency in donors and non-donors (41% vs. 29%; p = 0.23). Patients with DC had similar odds of donation as those without DC (odds ratio 1.70, 95% CI 0.72–4.03), including after adjustment for age and Glasgow Coma Scale score (odds ratio 1.31, 95% CI 0.53–3.24). The most common reason eligible patients failed to convert to donor status was failure to pursue organ procurement because of the belief that the patient would not progress to neurological death or be a candidate for donation following cardiac death. Decompressive craniectomy was not uncommon among referrals to organ procurement organizations who ultimately become solid organ donors. Continued communication between the organ donation coordinators and the treating team has potential to decrease missed opportunities for organ donation.