We aimed to evaluate potential brain dead organ donors (BDODs), the problems encountered during their ICU course, and the outcomes at our institution.
Methods. We reviewed the charts of patients who developed brain death at our institution between August 1997 and June 2006. The etiology of brain death (whether the organs were procured or not) and problems encountered in the ICU (ie, cardiac arrest, hypotension, diabetes insipidus, and acute lung injury) were recorded. Results. A total of 33 potential BDODs were analyzed. The most common etiology of brain death in potential BDODs was subarachnoid hemorrhage (n=16, 49%) followed by hypoxic encephalopathy (n=9, 27%) and traumatic brain injury (n=6, 18%). No cardiac arrest or loss of potential organ donors secondary to hemodynamic instability occurred in potential BDODs. The main problems encountered in these patients during their ICU stay were hypotension (n=26, 81%), hypothermia (n=14, 52%), diabetes insipidus (n=42%), and acute lung injury (n=7, 39%). Among these potential BDODs, only 15 (46%) became actual BDODs. The main reason for precluding organ donation was familial refusal (n=17, 52%). ICU management of BDODs is frequently associated with numerous problems. However, optimal ICU care of these patients can help improve their homeostasis and minimize the loss of potential BDODs. In our potential BDODs, the main obstacle to organ procurement was familial refusal. Further studies should focus on strategies that might help overcome this issue.