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A new study published in the Canadian Medical Association Journal shows that the number of patients being declared "brain dead" has decreased over the past 10 years, but this has serious implications for organ donations and transplants.
The researchers from Canada say they believe their findings may be a result of better injury prevention and improved care. But since the majority of organ donations rely on those who suffer from neurological death, this could lead to increased donor shortage.
To reach their findings, the team conducted a prospective cohort study involving 2,788 patients from Alberta, who were admitted to regional intensive care units as a result of various brain injuries over a 10.5-year period.
Results of the analysis revealed that the number of neurological deaths as a result of brain injuries decreased over the study period.
The percentage of patients who progressed to neurological death stood at 8.1% in 2002 and 9.6% in 2004, but it reduced to 2.2% in 2010. Patients suffering from traumatic brain injury saw the biggest decrease in neurological death.
The study authors suggest that correlating reductions in traffic collisions and increases in improved care may have had an impact on the reduction of the number of patients suffering neurological death.
Data from Alberta Transportation revealed that the number of traffic-related deaths had reduced by 24%, from 404 deaths in 2006 to 307 deaths in 2010.
The number of nonfatal road collisions also reduced from 18,831 in 2006 to 13,552 in 2010.
Furthermore, the researchers say that clinical care of patients with brain injury has also improved in Canada over the last decade. They note there has also been an increase of specialists in neurocritical care, as well as improvements in surgery that can help reduce brain swelling.
The study authors say:
"We found that the proportion of patients with brain injury who progressed to neurologic death decreased during the study period, particularly among those with traumatic brain injury.
The reasons for our findings cannot be determined with certainty from these data, but the change may reflect positive societal and health care system developments in injury prevention and care."
The researchers say although it is positive news that the number of people suffering neurological death has reduced, these findings have negative implications for the number of organ donations and transplants.
According to the researchers, organ donations after neurological death account for around 50% of all kidney transplants, 75% of liver transplants, 90% of lung and pancreas transplants, and all heart and small bowel transplants.
But if neurological deaths decrease, this means fewer organ donations and longer transplant waiting lists. The researchers say their findings may explain Canada's current shortage of organ donations.
According to the Canadian Society of Transplantation, more than 4,000 Canadians are currently on the waiting list for an organ transplant, and last year there were only 1,800 transplants performed.
"Our results likely help explain the relatively stagnant or even declining rates of deceased organ donation in some Canadian jurisdictions," the researchers say.
"However, the rates of donation after neurologic death in Canada are unlikely to rise in the future. Thus, if organ transplantation rates are to increase, it will need to occur through alternative approaches, such as living donation, donation after cardiocirculatory death and innovations aimed at improving the use of donated organs."
Medical News Today recently reported on a study detailing the discovery of a new target for drugs that combat brain cell death.
Written by Honor Whiteman
Copyright: Medical News Today
Not to be reproduced without the permission of Medical News Today.
Incidence of neurologic death among patients with brain injury: a cohort study in a Canadian health region, Andreas H. Kramer, David A. Zygun, Christopher J. Doig, Danny J. Zuege, published in the Canadian Medical Association Journal, 28 October 2013. Abstract
Visit our Neurology / Neuroscience category page for the latest news on this subject.
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