Since the pioneer description of Mollaret and Goulon in 1959, the concept of brain death has evolved over the years and the clinical triad of complete and irreversible coma, loss of spontaneous respiration and abolished brain stem reflexes has gained universal acceptance designating brain death. The debate is over the time, number of physicians deciding and confirmatory laboratory tests. The most important practical consequence of brain death is harvesting healthy organs for transplantation. In Turkey the law requires four physicians (anesthesiologist, cardiologist, neurologist and neurosurgeon) for determination and declaration of brain death. In the year 2007, the reported number of brain deaths in Turkey has been 563. In 349 (58.75 %) cases families refused organ donation. In 245 (41.24 %) patients family response was positive. In this group 22 patients proved to be unsuitable donors either for medical reasons or occurrence of cardiac arrest in the meantime. Finally 223 (37.54 %) cases became donors which corresponded to 3.18 donors/million population, which is very below the ideal number of 40 donors/million population. The organs harvested from these patients were: 397 kidneys, 197 livers, 63 hearts, 102 corneas, 14 pancreases, 2 lungs and 2 duodenums which totaled to 777 organs. The brain deaths reported in Turkey from 2002 until 2006 were 148, 163, 220, 229 and 270 respectively. The increase of brain death cases as shown by the above figures is not sufficient for supplying the need of patients waiting for organs. The medical staff should receive more education about the subject and people need more information including different aspects of the problem which eventually would promote organ donation.
Volume : 6
Issue : 4
Pages : 30
Departments of Neurosurgery1,
Baskent University, Ankara, Turkey