TY - JOUR
T1 - Brain death and postmortem organ donation
T2 - report of a questionnaire from the CENTER-TBI study
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.
AU - CENTER-TBI Investigators
AU - van Heugten, Caroline M.
PY - 2018/11/16
Y1 - 2018/11/16
N2 - BackgroundWe aimed to investigate the extent of the agreement on practices around brain death and postmortem organ donation.MethodsInvestigators from 67 Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study centers completed several questionnaires (response rate: 99%).ResultsRegarding 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.ConclusionsThis 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 - BackgroundWe aimed to investigate the extent of the agreement on practices around brain death and postmortem organ donation.MethodsInvestigators from 67 Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study centers completed several questionnaires (response rate: 99%).ResultsRegarding 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.ConclusionsThis 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 - Traumatic brain injury
KW - Brain death
KW - Ethics
KW - Postmortem organ donation
KW - Withdrawing life-sustaining measures
KW - Ventricular drainage
KW - VARIABILITY
KW - GUIDELINES
KW - POLICIES
U2 - 10.1186/s13054-018-2241-4
DO - 10.1186/s13054-018-2241-4
M3 - Article
SN - 1364-8535
VL - 22
JO - Critical Care
JF - Critical Care
IS - 1
M1 - 306
ER -