TY - JOUR
T1 - Brain death and postmortem organ donation
T2 - report of a questionnaire from the CENTER-TBI study
AU - CENTER-TBI Investigators and Participants
AU - van Veen, Ernest
AU - van der Jagt, Mathieu
AU - Cnossen, Maryse C
AU - Maas, Andrew I R
AU - de Beaufort, Inez D
AU - Menon, David K
AU - Citerio, Giuseppe
AU - Stocchetti, Nino
AU - Rietdijk, Wim J R
AU - van Dijck, Jeroen T J M
AU - Kompanje, Erwin J O
PY - 2018/11/16
Y1 - 2018/11/16
N2 - BACKGROUND: We aimed to investigate the extent of the agreement on practices around brain death and postmortem organ donation.METHODS: Investigators from 67 Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study centers completed several questionnaires (response rate: 99%).RESULTS: Regarding practices around brain death, we found agreement on the clinical evaluation (prerequisites and neurological assessment) for brain death determination (BDD) in 100% of the centers. However, ancillary tests were required for BDD in 64% of the centers. BDD for nondonor patients was deemed mandatory in 18% of the centers before withdrawing life-sustaining measures (LSM). Also, practices around postmortem organ donation varied. Organ donation after circulatory arrest was forbidden in 45% of the centers. When withdrawal of LSM was contemplated, in 67% of centers the patients with a ventricular drain in situ had this removed, either sometimes or all of the time.CONCLUSIONS: This study showed both agreement and some regional differences regarding practices around brain death and postmortem organ donation. We hope our results help quantify and understand potential differences, and provide impetus for current dialogs toward further harmonization of practices around brain death and postmortem organ donation.
AB - BACKGROUND: We aimed to investigate the extent of the agreement on practices around brain death and postmortem organ donation.METHODS: Investigators from 67 Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study centers completed several questionnaires (response rate: 99%).RESULTS: Regarding practices around brain death, we found agreement on the clinical evaluation (prerequisites and neurological assessment) for brain death determination (BDD) in 100% of the centers. However, ancillary tests were required for BDD in 64% of the centers. BDD for nondonor patients was deemed mandatory in 18% of the centers before withdrawing life-sustaining measures (LSM). Also, practices around postmortem organ donation varied. Organ donation after circulatory arrest was forbidden in 45% of the centers. When withdrawal of LSM was contemplated, in 67% of centers the patients with a ventricular drain in situ had this removed, either sometimes or all of the time.CONCLUSIONS: This study showed both agreement and some regional differences regarding practices around brain death and postmortem organ donation. We hope our results help quantify and understand potential differences, and provide impetus for current dialogs toward further harmonization of practices around brain death and postmortem organ donation.
KW - Brain Death
KW - Brain Injuries, Traumatic/complications
KW - Europe
KW - Humans
KW - Internationality
KW - Surveys and Questionnaires
KW - Tissue and Organ Procurement/legislation & jurisprudence
KW - Trauma Centers/organization & administration
U2 - 10.1186/s13054-018-2241-4
DO - 10.1186/s13054-018-2241-4
M3 - Article
C2 - 30446017
SN - 1466-609X
VL - 22
SP - 306
JO - Critical care (London, England)
JF - Critical care (London, England)
IS - 1
ER -