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Notifications and donors of organs and tissues for transplantation: discard and cost estimates for the public health system

Objective: Analyze the number of discards of organs and tissues from patients with Brain Death in the state of Paraná and estimate the financial costs for the health system. Methods: Exploratory cross-sectional retrospective study. All deaths occurred in the state of Paraná, Brazil, from 2011 to 2015. Results: A total of 1,013 patients were studied; the number of donors for single organs was 1,013, and the number of donors for paired tissues/organs was 2,026. Approximately 34.5% of transplant costs were associated with discards. Discards of corneas (30.0%) and eyeballs (93.5%) increased over the course of the study period. Heart, lung, and pancreas discards remained relatively stable. There was a 100% increase in liver discards, and the number of discarded kidneys increased from 9 in 2011 to 60 in 2015. The heart had the lowest discard percentage (0.8%). Conclusion: Discards of corneas and eyeballs were high, especially in older age groups, suggesting that procurement could have been avoided. Liver and kidney discards increased considerably. Studies of this nature should be carried out to evaluate the quality and effectiveness of the donation and transplantation processes, as well as the outcomes in terms of financial costs to the public system.