Organ Donation After Cardiac Death in Children: Acceptance of a Protocol by Multidisciplinary Staff

2012 ◽  
Vol 21 (5) ◽  
pp. 322-327 ◽  
Author(s):  
Allison S. Cowl ◽  
Brian M. Cummings ◽  
Phoebe H. Yager ◽  
Brenda Miller ◽  
Natan Noviski

Background Organ donation after cardiac death is increasingly implemented, with outcomes similar to those of organ donation after brain death. Many hospitals hesitate to implement a protocol for donation after cardiac death because of the potential negative reactions among health care providers. Objectives To determine the acceptance of a protocol for donation after cardiac death among multidisciplinary staff in a pediatric intensive care unit. Methods An anonymous, 15-question, Likert-scale questionnaire (scores 1–5) was used to determine the opinions of staff about donation after brain death and after cardiac death in a pediatric intensive care unit of a tertiary-care university hospital. Results Survey response rate was 67% (n = 60). All physicians, 89% of nurses, and 82% of the remaining staff members stated that they understood the difference between donation after brain death and donation after cardiac death; staff supported both types of donation, at rates of 90% and 85%, respectively. Staff perception was the same for each type of donation (ρ = 0.82; r = 0.92; P < .001). The 20 staff members who provided care directly to patients who were donors after cardiac death considered such donation worthwhile. However, 60% of those providers offered suggestions to improve the established protocol for donation. Conclusions The multidisciplinary staff has accepted organ donation after cardiac death and has fully integrated this kind of donation without reported differences from their acceptance of donation after brain death.

2018 ◽  
Author(s):  
Thomas I. Cochrane

Brain death is the state of irreversible loss of the clinical functions of the brain. A patient must meet strict criteria to be declared brain dead. They must have suffered a known and demonstrably irreversible brain injury and must not have a condition that could render neurologic testing unreliable. If the patient meets these criteria, a formal brain death examination can be performed. The three findings in brain death are coma or unresponsiveness, absence of brainstem reflexes, and apnea. Brain death is closely tied to organ donation, because brain-dead patients represent approximately 90% of deceased donors and thus a large majority of donated organs. This review details a definition and overview of brain death, determination of brain death, and controversy over brain death, as well as the types of organ donation (living donation versus deceased donation), donation after brain death, and donation after cardiac death. A figure presents a comparison of organ donation after brain death and after cardiac death, and a table lists the American Academy of Neurology Criteria for Determination of Brain Death. This review contains 1 highly rendered figure, 3 table, and 20 references.


2017 ◽  
Author(s):  
Thomas I. Cochrane

Brain death is the state of irreversible loss of the clinical functions of the brain. A patient must meet strict criteria to be declared brain dead. They must have suffered a known and demonstrably irreversible brain injury and must not have a condition that could render neurologic testing unreliable. If the patient meets these criteria, a formal brain death examination can be performed. The three findings in brain death are coma or unresponsiveness, absence of brainstem reflexes, and apnea. Brain death is closely tied to organ donation, because brain-dead patients represent approximately 90% of deceased donors and thus a large majority of donated organs. This review details a definition and overview of brain death, determination of brain death, and controversy over brain death, as well as the types of organ donation (living donation versus deceased donation), donation after brain death, and donation after cardiac death. A figure presents a comparison of organ donation after brain death and after cardiac death, and a table lists the American Academy of Neurology Criteria for Determination of Brain Death. This review contains 1 highly rendered figure, 3 table, and 20 references.


2013 ◽  
Vol 41 (7) ◽  
pp. 1733-1744 ◽  
Author(s):  
Ajit A. Sarnaik ◽  
Jeff A. Clark ◽  
Kathleen L. Meert ◽  
Ashok P. Sarnaik

2021 ◽  
Vol 56 (6) ◽  
pp. 638-645
Author(s):  
Faruk Ekinci ◽  
◽  
Dinçer Yıldızdaş ◽  
Özden Özgür Horoz ◽  
Faruk İncecik ◽  
...  

Author(s):  
Carl Waldmann ◽  
Andrew Rhodes ◽  
Neil Soni ◽  
Jonathan Handy

This chapter discusses death and dying, and includes discussion on confirming death using neurological criteria (brainstem death), withdrawing and withholding treatment, organ donation after brain death (DBD), and organ donation after circulatory determination of death (DCD). Death is common in the intensive care unit (ICU) and it is important to identify patients whose condition meets the criteria for brainstem death testing as well as patients where continued treatment is not considered to be in their overall best interests. Confirming death using neurological criteria allows the relatives to be presented with the certainty of a diagnosis of death whether organ donation is possible or not. Decisions to withraw treatment are common in the ICU and are associated with approximately 50% of all deaths in the ICU. The decision is made by the multidisciplinary team in consultation with the patient’s relatives and taking into account the patient’s values and preferences. In both situations the possibility of organ donation should be considered and explored, and, when it is a possibility, it should be routinely offered to the relatives as an end-of-life care option.


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