Universität zu Köln

Schulte, Kevin, Borzikowsky, Christoph ORCID: 0000-0002-5489-0032, Rahmel, Axel, Kolibay, Felix, Polze, Nina, Fraenkel, Patrick, Mikle, Susanne, Alders, Benedikt, Kunzendorf, Ulrich and Feldkamp, Thorsten (2018). Decline in Organ Donation in Germany A Nationwide Secondary Analysis of All Inpatient Cases. Dtsch. Arztebl. Int., 115 (27-28). S. 463 - 478. COLOGNE: DEUTSCHER AERZTE-VERLAG GMBH. ISSN 1866-0452

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Abstract

Background: The annual number of post-mortem organ donations in Germany has declined by more than 30% since 2010. The causes of this development have not yet been adequately determined. Methods: All patients hospitalized in Germany between 2010 and 2015 (112 172 869 hospitalizations in total) were included in this nationwide secondary analysis. Among the deceased patients we identified those who had died in the presence of a brain damage and for whom organ donation was not excluded either by a medical contraindication or by the patient's not having been artificially ventilated. The analysis was also conducted separately for six German university hospitals. Results: Over the period 2010-2015, the number of potential organ donors per year in Germany rose by 13.9%, from 23 937 to 27 258. This development was due to an increase in the number of deaths with severe brain damage as well as an increase in the percentage of patients who were treated with invasive ventilation before death. The contact quotient, i.e., the percentage of potential donors for whom contact was made with the German Foundation for Organ Transplantation (Deutsche Stiftung Organtransplantation, DSO) fell over this period from 11.4% to 8.2%. At the same time, the realization quotient (the percentage of potential donors who became actual donors) fell from 5.4% to 3.2%, and the conversion quotient (the percentage of potential donors for whom contact was made who became actual donors) fell from 47% to 39.1%. From 2010 to 2012, the falling realization quotient was accounted for mainly by the falling conversion quotient; from 2012 to 2015, it was accounted for mainly by the falling contact quotient. The contact and realization quotients among the six university hospitals studied differed markedly (by factors of 17.5 and 23.3, respectively), while the conversion quotients differed only minimally (by a factor of 1.3). Conclusion: The decline in post-mortem organ donation is due to a deficiency in the recognition and reporting of potential organ donors in hospital. If this process were better supported on the organizational and political level, far more organs could be transplanted.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schulte, Kevin UNSPECIFIED UNSPECIFIED UNSPECIFIED Borzikowsky, Christoph UNSPECIFIED orcid.org/0000-0002-5489-0032 UNSPECIFIED Rahmel, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Kolibay, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Polze, Nina UNSPECIFIED UNSPECIFIED UNSPECIFIED Fraenkel, Patrick UNSPECIFIED UNSPECIFIED UNSPECIFIED Mikle, Susanne UNSPECIFIED UNSPECIFIED UNSPECIFIED Alders, Benedikt UNSPECIFIED UNSPECIFIED UNSPECIFIED Kunzendorf, Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Feldkamp, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-179862
DOI:	10.3238/arztebl.2018.0463
Journal or Publication Title:	Dtsch. Arztebl. Int.
Volume:	115
Number:	27-28
Page Range:	S. 463 - 478
Date:	2018
Publisher:	DEUTSCHER AERZTE-VERLAG GMBH
Place of Publication:	COLOGNE
ISSN:	1866-0452
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language AUDIT Multiple languages Medicine, General & Internal Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17986