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Analysis of factors involved in brain-death donor processing for face transplantation in Korea: How much time is available from brain death to transplantation?

Archives of Plastic Surgery 2019년 46권 5호 p.405 ~ 413
 ( Hong Jong-Won ) - Yonsei University College of Medicine Department of Plastic and Reconstructive Surgery

 ( Chung Soon-Won ) - Yonsei University College of Medicine Department of Plastic and Reconstructive Surgery
 ( Ahn Sung-Jae ) - Yonsei University College of Medicine Department of Plastic and Reconstructive Surgery
 ( Lee Won-Jai ) - Yonsei University College of Medicine Department of Plastic and Reconstructive Surgery
 ( Lew Dae-Hyun ) - Yonsei University College of Medicine Department of Plastic and Reconstructive Surgery
 ( Kim Yong-Oock ) - Yonsei University College of Medicine Department of Plastic and Reconstructive Surgery

Abstract


Background: Face transplantation has naturally evolved from reconstructive procedures. However, few institutions perform face transplantations, because it is time-consuming and it is necessary to justify non-vital organ transplantation. We investigated the process of organ donation from brain-dead patients and the possibility of incorporating face transplantation into the donation process.

Methods: A retrospective review was performed of 1,074 brain-dead patients from January 2015 to December 2016 in Korea. We analyzed the time intervals from admission to brain death decisions (first, second, and final), the causes of brain death, and the state of the transplanted organs.

Results: The patient base (n=1,074) was composed of 747 males and 327 females. The average period between admission to the first brain death decision was 8.5 days (±15.3). The average time intervals between the first brain death decision and medical confirmation using electroencephalography and between the first brain death decision and the final determination of brain death were 16 hours 58 minutes (±14 hours 50 minutes) and 22 hours 57 minutes (±16 hours 16 minutes), respectively. The most common cause of brain death was cerebral hemorrhage/stroke (42.3%), followed by hypoxia (30.1%), and head trauma (25.2%).

Conclusions: When face transplantation is performed, the transplantation team has 22 hours 57 minutes on average to prepare after the first brain death decision. The cause of brain death was head trauma in approximately one-fourth of cases. Although head trauma does not always imply facial trauma, surgeons should be aware that the facial tissue may be compromised in such cases.

키워드

Brain death; Transplantation; Tissue and organ procurement
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