Low incidence of brain death and organ donation in Sweden. Analyses of a six-year prospective registration of all deceased patients in intensive units in Southern Sweden

Sweden is among those countries in Europe that have the lowest number of organ donors per million population (PMP). Because of the low numbers of actual donors, it is important to identify the total number of potential donors. Thus, a prospective registration of all deceased patients at all intensive care units was introduced in the Southern Healthcare Region of Sweden, which has a population of 1.6 million. During the six years from 1999 to 2004, 3,760 deaths were recorded. Only 251 patients (7%) of all ages were diagnosed with brain death, corresponding to 26 patients PMP and year. Of these, 194 cases (20 PMP) were classified as potential organ donors, defined as brain death without medical contraindications against organ donation. Consent for organ donation was given in slightly more than half of these cases (54%) thus, there were only around 11 organ donors PMP and year. The continuous registration in Southern Sweden has been a very important tool for evaluation of what forms of action should be taken to promote organ donation. As part of a computerised system for quality assurance in intensive care now being introduced in many parts of Sweden, registration may become an instrument of quality assurance for organ donation nationwide.