• J L Bustos, K Surt, and C Soratti.
• National Institute for Organ Donation and Transplantation and INCUCAI, Buenos Aires, Argentina.
• Transplant. Proc. 2006 Dec 1;38(10):3697-9.

BackgroundIn Argentina, the rate of cadaveric organ donation per million inhabitants has recently increased to 10.5 (it was previously <7).PurposeTo overcome this challenge, the National Institute for Organ Donation and Transplantation (INCUCAI) created a proactive donor detection plan performed by intensive care unit (ICU) physicians (hospital transplantation coordinators) from 90 selected hospitals across the country.MethodsA prospective, observational study of patients in severe coma status was conducted from September 2003 to December 2005. We enrolled hospitalized patients who displayed a Glasgow Coma Scale (GCS) of 7 or less and who were admitted to ICUs. Data included demographics, etiology of coma, cardiac arrest, brain death, discharge or derivation, and positive/negative donation.ResultsAmong 9841 enrolled patients, we excluded 498 who were discharged to another hospital or had unknown outcomes, leaving 9343 for analysis including 64% males and 36% females of overall mean age 50 +/- 19 years (adults) and 5 +/- 4 years (children). Herein, we have highlighted the high risk of death during the first 2 days in the ICU of patients with GCS 7 or less. Gunshot to the head-injured patients and those with hemorrhagic strokes were less likely to survive. In this study, cardiac arrest events and organ donors (OD) GCS 7 or less ratios emerged as quality control markers of ICU care, unraveling problems of potential donor maintenance or inadequate policies.ConclusionsThe GCS 7 or less surveillance program seemed to be a valuable tool for identifying organ donors and potentially treatable events, such as the high rate of cardiac arrest observed in this study.

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