Availability of organs for transplantation: a three year study.

Records were examined of all medically eligible potential organ donors diagnosed as brain stem dead over a three-year period in the intensive care units covered by the Nottingham, England, renal transplant unit. At present 40 kidneys per million population are needed each year for transplantation in Great Britain. Of 50 kidneys per million population identified by the survey as suitable for transplantation, only 25 were referred for retrieval. Lower percentages of hearts and livers were retrieved. Despite a stated policy of the intensive care units to refer brain stem dead patients for consideration as organ donors, there were instances of nonreferral by medical staff and refusal to donate by relatives. The authors urge that senior medical staff be designated as organ requesters and that well trained nurses be encouraged to introduce the subject, especially if required request becomes law.