The number of organ donations in Germany fell by 28%, from 1296 to 932, in the period from 2010 to 2019 (1). By analyzing all German hospital cases, we have previously shown that this is due to a deficiency in the recognition and reporting of potential organ donors (2). In addition, our study suggested that the organ donation potential in Germany has increased in recent years. However, several studies have shown that patients with severe brain damage benefit from a decompressive craniectomy (for example, see [3]). It is therefore conceivable that the decompressive craniectomy procedure has been increasingly performed in patients with severe brain damage in recent years. As a result, fewer patients would have suffered an irreversible loss of brain function, as they were either saved by this measure or died from another complication. Therefore, in contrast to what we previously claimed (2), these patients would not have been considered as organ donors. In turn, the detection and reporting deficiencies are also likely to have been overestimated.
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