Key result
DOAC use shows no association with ICH-related organ donation rates despite declining annual ICH incidence.
Why the study?
Although direct oral anticoagulant (DOAC) prescriptions in Germany have steadily increased and severe intracranial hemorrhage (ICH) under DOACs is challenging to treat, whether rising DOAC use leads to severe ICH and indirectly influences postmortem organ donation had not been investigated.
Does the increasing prescription rate of direct oral anticoagulants (DOACs) increase the rate of intracranial hemorrhage leading to postmortem organ donation in Germany?
Observational
Does the increasing prescription rate of direct oral anticoagulants (DOACs) increase the rate of intracranial hemorrhage leading to postmortem organ donation in Germany?
Answers are grounded in this paper and cite their sources.
Increasing prescription rates of DOACs in Germany have not led to an increase in severe intracranial hemorrhage resulting in postmortem organ donation.
BACKGROUND: Since the introduction of direct oral anticoagulants (DOACs), the number of prescriptions throughout Germany has been steadily increasing, while "classic" anticoagulants have an increasingly smaller market share. The treatment of severe bleeding complications under DOAC therapy is sometimes difficult. Intracranial hemorrhage (ICH) in particular poses a major challenge for practitioners. It has not yet been investigated whether the increasing number of DOACs prescribed leads to severe ICH and thus has an indirect influence on postmortem organ donation. METHODS: The prescription rates for heparins, coumarins since 2002 and DOACs for Germany since market introduction were analyzed with data from the Deutsche Stiftung Organtransplantation (DSO) using a multivariable Poisson regression model. RESULTS: The Poisson regression showed that neither the proportion of DOACs with available antidote nor the proportion of DOACs without available antidote had a significant influence on the rate of ICHs. Time, on the other hand, proved to be a significant predictor for the rate of ICHs, with the rate of ICHs decreasing by an estimated 5% per year. CONCLUSION: This study provides the first evidence to suggest that DOACs have not led to an increase in organ donation since they have become part of everyday clinical practice and the number of prescriptions has continued to rise. The clinical availability of antidotes for some of these DOACs also showed no significant influence in the present patient clientele.
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Raimann et al. (2026) conducted an observational in Intracranial hemorrhage leading to postmortem organ donation. Direct oral anticoagulants (DOACs) with or without available antidote vs. Heparins and coumarins was evaluated on Rate of intracranial hemorrhage leading to postmortem organ donation. DOAC prescription proportions (with or without antidote) had no significant influence on ICH-related organ donation rates, while ICH rates decreased by an estimated 5% per year.
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