• Philippe Le Conte, David Riochet, Laetitia Labastire, Jean Christophe Auneau, Estelle Legeard, Myriam Van Tricht, Eric Batard, Emmanuel Montassier, Arnaud Martinage, and Gilles Potel.
• Pôle Urgence, Centre Hospitalier Universitaire de Nantes, France. philippe.leconte@chu-nantes.fr
• Am J Emerg Med. 2012 Jan 1;30(1):170-3.

ObjectiveIn France and in Belgium, as in many countries, there is a shortage of organs for transplantation, which has led to strategies to recruit older potential donors who may die of stroke.MethodsWe conducted a post hoc analysis to identify potential organ donors with cardiac function among a population of dying patients in emergency departments. This population had been selected for a separate multicenter prospective observational study. We identified patients who died of a neurologic cause but had no clinical findings affecting their donor status.ResultsOf 2420 patients in the study, 407 died of a neurologic cause; and 233 of these were excluded because of clinical factors that made them ineligible as organ donors. The remaining 174 patients (7.2% of dying patients) could be considered potential organ donors. Their mean age was 75.2 ± 11 years. Sixty-eight (39%) were intubated, and 60 of these (34.5%) were mechanically ventilated. In addition, 94 patients (54%) died within 12 hours (median, 9.3 hours) after admission; and 13 (7%) died while receiving a maximum level of care. No diagnostic procedures were performed to assess brain death.ConclusionA significant number of patients who die in emergency departments could be organ donors, including approximately 7% between 60 and 85 years of age with life-threatening neurologic diseases. However, this percentage may be reduced by family opposition. Emergency physicians should collaborate with intensive care units and local organ donation teams to optimize end-of-life care and maximize the number of potential donors.Copyright © 2012 Elsevier Inc. All rights reserved.

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