Research Information System
Comprehensive medicine, vol.17, no.2, pp.88-94, 2025 (Peer-Reviewed Journal)
Objective: Ensuring the hemodynamic stability of patients following catastrophic brain injury is a very challenging process. The organ transplantation rate increased significantly with donor management (DM) provided in accordance with the goals set for DM-goals (DMGs). However, the factors affecting the achievement of these goals are unclear. Materials and Methods: We included adult patients diagnosed with brain death (BD), also who was subsequently given at least 24 hours of donor care between January 1st, 2011 and August 1st, 2023 in the study. The DMG scores of each patient were calculated at the time of BD-detection, twenty-four hours before, 2, 6, 12, and 24 hours after the brain-death-detection-time. Results: Among 194 BD patients, 78 patients who received 24-hour donor care were included in the study. The DMG scores of patients with trauma were statistically higher than those of patients who had other reasons for BD (95% CI: [1.4–17]; p:0.014). The results showed a significant decrease at 24 hours after detection, while there was no change at 6 and 12 hours after BD-detection in DMG scores (p<0.001). Also, the results showed that while the higher mean arterial pressure (MAP) recorded at 6,12 and 24 hours after BD-detection during DM increased the rate of liver and kidney transplantation (95% CI, 16.3–34.8]; p<0.001, [95% CI, 9.3–28.8]; p<0.001, respectively). Moreover, the most common problems encountered before BD-detection were diabetes-in- sipidus (30%) and fever (23%). Conclusion: Although more studies are needed to provide more effective DM and increase transplantation rates, more comprehensive criteria, including organ perfusion parameters, should be determined, and the MAP target should be increased without hesitation in the use of vasopressor drugs.