Organ shortage is still the major problem that confronts the organ transplantation worldwide including Saudi Arabia. The purpose of this study is to evaluate the reasons and causes for not harvesting organs from consented cases. Retrospective study was conducted for the year 2003 based on the national registry of all Brain Death (BD) cases followed up by Saudi Center for Organ Transplantation (SCOT). We concentrated on all the cases that had been diagnosed as BD and on whom consent was obtained from the next of kin for organ harvesting. Our aim was to find out how many of these group of consented cases were not in actual fact harvested and why.
Out of 360 reported cases, 219 (61%) were documented as BD; of these, 167 (76%) were approached for donation and 49 (29%) agreed. From these 49 consented, 10 cases were not retrieved (20.4%) due to i) Medical reasons in 3 cases (sepsis, malignancy), ii) One for technical reason (unable to reach donor hospital), iii) Two for sudden cardiac arrest iv) Four cases because of withdrawal of consent by family (24 hrs from initial consent). The mean time gap between obtaining consent to harvesting of these 39 cases were 10 hours (range 2-29 hrs). While in the 7 (70%) non- harvested cases, (excluding the 3 cases (30%) that were found not suitable on medical grounds) the duration between obtaining the consent and the cardiac arrest ranged between 7 to 36 hours with a mean of 15 hours. The majority of non-harvested cases were failed due to prolonged time taken in arranging the team for multi organ retrieval. Delay of harvesting after getting consent is the principal element of these failures (57%). We intensely recommend that by having an ideal time (less than 6 hours) for organ procurement after obtaining consent is absolute.