Time from the onset of Brain Death (BD) to harvesting plays a vital role in the success and quality of cadaveric organ transplantation. We studied this and analyzed the source of the delays in relation to the various phases that precede the harvesting. The study looked into the different phases a BD case undergoes from the time of admission, reporting the case to the procurement centre, through documentation of the BD diagnosis till the time of harvesting and/or cardiac arrest. It covers the period of 1999-2003 as followed up by the Saudi Centre for Organ Transplantation (SCOT).
A total of 1834 cases were reported to SCOT for the whole 5 years. Of these reported cases, 1077 cases (58.7%) were documented as brain dead (BD) and more than 80% of these cases were reported in the first week of admission with a mean of 1.8 days noted between the reporting of the cases to the actual documentation of the BD diagnosis (range of 12 hours to 42 days). The length of ICU stay from admission till retrieval or cardiac arrest ranged from 24 hours to 102 days with a mean of 10.2 days. The time between admission and reporting ranges from 8 hours to 102 days with a mean of 5.5 days. Among the successful (harvested) cases, the duration from documentation of BD till harvesting were 0-21 days with an average of 2 days while the non-retrieved cases ranged from 0-43 days with a mean of 5 days. We observed that less than 30% of cases could be sustained beyond one week after documentation. Neither the cause nor the age of BD played any role in determining the above durations. Exerting more efforts to accelerate reporting and documentation of BD will greatly benefit the organ transplantation both quantitatively and qualitatively.