Currently more than 100,000 patients are on the organ transplant list in the US alone. Many patients die each year without receiving a life saving organ. Increasing organ donation rates will improve this situation and will save many lives.

One of the biggest sources for organ donation are the patients with severe traumatic brain injuries who progress to brain death. Even after the patient is pronounced brain dead there is often a delay in time until organ procurement takes palce. Obtaining consent for organ donation from the family is one of the biggest obstacles towards a successful donation.

Does it matter how soon the organs are taken after the patient is declared brain dead? Does it decrease the viability of organs and reduce the number of organs harvested if the waiting time is prolonged?

Currently there is no maximum established waiting time from the onset of brain death to when a successful donation is possible. A study published in the June issue of the Trauma Journal attempts to answer those questions. The study was conducted in Southern California.

The authors of this study found no decrease in the proportion of organ procurement with a longer waiting time. Indeed, according to this publication, a successful organ donation is possible even more than 60 hours after brain death.

Furthermore, the rate of heart and pancreas procurement increased with a longer delay after the diagnosis of brain death was made. The exact reasons for this finding are unclear. The authors suggested that many more patients were hemodynamically stable for organ procurement with a longer time delay.

These findings are supported by previous studies. It was shown that the graft viability might improve after kidney donation with a longer time allowed to pass after the brain death. Better hemodynamic status and attenuated inflammatory response with longer waiting times were attributed to a better kidney graft function in the recipient.

Of course, better organ procurement rates do not guarantee better organ graft survival in the recipient over time. The findings of this study are encouraging, nevertheless. So far there is no established maximum time between the diagnosis of brain death and organ donation. After all, sooner or later is better than never at all.