Epidemiological changes in potential heart donors after brain death: a retrospective 15 year cohort study

Changes in the causes of brain death may influence the numbers of hearts that can be procured and transplanted. We retrospectively investigated whether the distribution of causes responsible for brain death have changed over a 15-year period in a cohort of 1286 potential heart donor (aged ≤ 60), and whether it influenced heart procurement. Between 2001 and 2016, the age of potential donors significantly increased (p < 0.0001) as well as the relative proportion of postanoxic brain death, while that of traumatic brain injury decreased (p = 0.0007). A significant increase in the use of norepinephrine was detectable. The number of transplanted hearts did not significantly change, with no differences in the age of donors or in the causes of brain death. According to our data, in our 15-year study period, significant changes in the causes of brain death occurred (indicated by a reduction in potential donors following traumatic brain injury) together with an increase in donor age. Nevertheless, the number of transplanted hearts did not change probably thanks to a modified donor management (as inferred by a different use of vasoactive drugs).