• Maria Rosa Pugliese, Daniela Degli Esposti, Ada Dormi, Nicola Venturoli, Paolo Mazzetti Gaito, Elena Sestigiani, Marzia Monti, Angelo Ghirardini, Alessandro Nanni Costa, and Lorenza Ridolfi.
• Transplant Referral Center, Emilia-Romagna Region.
• Prog Transplant. 2002 Dec 1;12(4):275-9.

ContextThe high demand for organs for transplantation necessitates enhancement of organ procurement activity worldwide.ObjectiveTo detect critical areas in the organ donation process and to assess whether careful monitoring of deaths in each intensive care unit could improve rates of identification of brain death.DesignRecords of patients who died in intensive care units in the Emilia-Romagna region between July 1, 1998 and June 30, 2000 were reviewed through the Donor Action program.ResultsOf the 2469 patients who died during the period studied, 1010 (40.9%) had severe brain damage, as indicated by a score of 3 on the Glasgow coma scale. A total of 857 patients with severe brain damage who had spent more than 6 hours in the intensive care unit (34.7% of all deaths) were considered as potential donors. Signs of brain death were observed in 383 (44.7%) of the 857 patients who died. Rates of identification of brain death increased from 36% to 55% during the study period.ConclusionConsidering that the characteristics of the study population had not changed, we believe that the Donor Action program was an important factor leading to the observed improvement in identification of brain death.

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