Institutional Variability in Brain-Dead Organ Donation Processes and Practices: A Multicenter Cohort Study

Yumoto, Tetsuya; Naito, Hiromichi; Hayakawa, Mineji; Yokobori, Shoji; Nishiyama, Kei; Atsumi, Takahiro; Tasaki, Osamu; Tsurukiri, Junya; Hayamizu, Mariko; Murahashi, Shimon; Hayashi, Munehiro; Nishimura, Takeshi; Goto, Yukari; Narumiya, Hiromichi; Mizutani, Atsushi; Miyajima, Mamoru; Shimazaki, Junya; Miura, Takeshi; Shima, Nozomu; Deuchi, Kazuki; Nakayasu, Hitomi; Kano, Hitoshi; Yorifuji, Takashi; Nakao, Atsunori; Japan Comprehensive Process for End-of-Life Care and Organ Donation after Brain Death (J-RESPECT) study group,

doi:10.1097/ccm.0000000000007120

Permalink : https://ousar.lib.okayama-u.ac.jp/70788

ID	70788
フルテキストURL	fulltext.pdf 1.76 MB
著者	Yumoto, Tetsuya Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University ORCID Kaken ID publons Naito, Hiromichi Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University ORCID Kaken ID publons Hayakawa, Mineji Department of Emergency Medicine, Hokkaido University Hospital Yokobori, Shoji Department of Emergency and Critical Care Medicine, Nippon Medical School Nishiyama, Kei Division of Emergency and Critical Care Medicine, Niigata University Graduate School of Medical and Dental Science Atsumi, Takahiro Department of Emergency and Disaster Medicine, Hamamatsu University School of Medicine Tasaki, Osamu Acute and Critical Care Center, Nagasaki University Hospital Tsurukiri, Junya Emergency and Critical Care Medicine, Tokyo Medical University Hachioji Medical Center Hayamizu, Mariko Department of Emergency Medicine, Hokkaido University Hospital Murahashi, Shimon Acute and Critical Care Center, Nagasaki University Hospital Hayashi, Munehiro Department of Emergency and Critical Care Medicine, Japanese Red Cross Medical Center Nishimura, Takeshi Department of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center Goto, Yukari Department of Emergency Medicine, Nagoya Ekisaikai Hospital Narumiya, Hiromichi Department of Emergency and Critical Care Medicine, Japanese Red Cross Kyoto Daini Hospital Mizutani, Atsushi Department of Emergency Medicine, Hamamatsu Medical Center Miyajima, Mamoru Emergency and Critical Care Center, Nagaoka Red Cross Hospital Shimazaki, Junya Department of Emergency and Critical Care Medicine, Kansai Medical University Medical Center Miura, Takeshi Department of Emergency and Critical Care Medicine, Institute of Medicine, University of Tsukuba Hospital Shima, Nozomu Department of Emergency and Critical Care Medicine, Wakayama Medical University Deuchi, Kazuki Division of Emergency and Critical Care Medicine, Niigata University Graduate School of Medical and Dental Science Nakayasu, Hitomi Emergency and Critical Care Medicine, Seirei Hamamatsu General Hospital Kano, Hitoshi Department of Emergency and Critical Care Medicine, Nippon Medical School Yorifuji, Takashi Department of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University ORCID Kaken ID publons researchmap Nakao, Atsunori Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Kaken ID Japan Comprehensive Process for End-of-Life Care and Organ Donation after Brain Death (J-RESPECT) study group
抄録	OBJECTIVES: To determine whether key institutional and clinical differences exist between highly and moderately active hospitals in Japan with respect to brain-dead organ donation practices. DESIGN: Retrospective multicenter cohort study. SETTING: Sixteen tertiary emergency and critical care centers across Japan. PATIENTS: All brain-dead organ donors from participating institutions who had at least one organ procured and transplanted between July 17, 2010, and December 31, 2023. Hospitals were categorized as highly active (≥ 14 donations) or moderately active (≤ 13 donations) during the study period. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Institutional donation practices were compared, including donor management strategies, use of vasopressors and corticosteroids, time intervals in the donation process, and frequency of multidisciplinary team meetings. A total of 204 donors were included; the median age was 47 years (interquartile range, 37–56), and 92 (45.1%) were female. Donor characteristics were similar between groups. Vasopressin was used in nearly all donors, though dosing protocols varied. Corticosteroid use was significantly higher in highly active hospitals compared with moderately active ones (58.3% vs. 38.0%; p = 0.004). Time from admission to coordinator notification was similar; however, time to family consent (median, 8 vs. 5 d; p < 0.001) and time to organ procurement (median, 12 vs. 9 d; p = 0.006) were longer in highly active hospitals. These hospitals also conducted more multidisciplinary meetings during donor management (median, 2 vs. 0; p < 0.001). CONCLUSIONS: Highly active hospitals demonstrated more intensive donor management practices, longer timeframes for key donation steps, and greater multidisciplinary engagement. Standardization of donation practices may enhance efficiency and support broader dissemination of effective institutional strategies to improve brain-dead organ donation rates in Japan.
キーワード	brain death critical illness decision-making organ transplantation patient care
発行日	2026-03-26
出版物タイトル	Critical Care Medicine
巻	54巻
号	6号
出版者	Ovid Technologies (Wolters Kluwer Health)
開始ページ	1319
終了ページ	1328
ISSN	0090-3493
NCID	AA00620383
資料タイプ	学術雑誌論文
言語	英語
OAI-PMH Set	岡山大学
著作権者	© 2026 The Author(s).
論文のバージョン	publisher
PubMed ID	41885543
DOI	10.1097/ccm.0000000000007120
Web of Science KeyUT	001782520500025
関連URL	isVersionOf https://doi.org/10.1097/ccm.0000000000007120
ライセンス	http://creativecommons.org/licenses/by-nc-nd/4.0/
助成番号	Yumoto, Tetsuya MD, PhD1; Naito, Hiromichi MD, PhD1; Hayakawa, Mineji MD, PhD2; Yokobori, Shoji MD, PhD3; Nishiyama, Kei MD, PhD4; Atsumi, Takahiro MD, PhD5; Tasaki, Osamu MD, PhD6; Tsurukiri, Junya MD, PhD7; Hayamizu, Mariko MD, PhD2; Murahashi, Shimon MD6; Hayashi, Munehiro MD8; Nishimura, Takeshi MD, PhD9; Goto, Yukari MD10; Narumiya, Hiromichi MD, PhD11; Mizutani, Atsushi MD12; Miyajima, Mamoru MD13; Shimazaki, Junya MD, PhD14; Miura, Takeshi MD, PhD15; Shima, Nozomu MD, PhD16; Deuchi, Kazuki MD4; Nakayasu, Hitomi MD17; Kano, Hitoshi MD3; Yorifuji, Takashi MD, PhD18; Nakao, Atsunori MD, PhD1; Japan Comprehensive Process for End-of-Life Care and Organ Donation after Brain Death (J-RESPECT) study group. Institutional Variability in Brain-Dead Organ Donation Processes and Practices: A Multicenter Cohort Study. Critical Care Medicine 54(6):p 1319-1328, June 2026. \| DOI: 10.1097/CCM.0000000000007120