Background: In this study, we analyzed the brain death patients and the donation rates in our neurosurgical field and we discuss the factors that may be important for maximizing these rates by review of literatures.
Methods: We performed a retrospective reviews of 3,016 patients who were admitted into the neurosurgical intensive care unit (NICU) from January 1, 2003 till December 31, 2008.
Results: A total of 300 deaths in the NICU was recorded. The major cause of death was cerebral lesion (92%, n=276). Among these deaths, the cerebral lesion was caused by hemorrhage (59%, n=176) and trauma (33%, n=100). The number of the medically or clinically suitable organ donors was 58 cases (19% of all deaths). Organ donation was realized in 37 cases (64% of all the potential donors). Among the non-donation cases, 16 cases refused organ donation, corresponding to a refusal rate of 28%. Two cases were not suitable due to infection, one case was not suitable due to early death, and two cases were not suitable due to legal problems.
Conclusions: Despite that Koreans overwhelmingly support organ donation and transplantation, the actual donation rate remain low. The organ donation rate of our city as 10 PMP was higher than that of whole country last year. As a preliminary study, it will be necessary to analyze the difference of organ donation rate between our city and other cities to identify predictors to affect on donation.

Keywords: Brain death, Organ donation, Organ transplantation, Intensive care unit, Neurosurgery