Explaining Brain Death: A Critical Feature of the Donation Process

1997 ◽  
Vol 7 (1) ◽  
pp. 14-21 ◽  
Author(s):  
Holly G Franz ◽  
William DeJong ◽  
Susan M Wolfe ◽  
Howard Nathan ◽  
Denise Payne ◽  
...  
Keyword(s):  
Brain Death ◽  
Organ Procurement ◽  
Healthcare Providers ◽  
Organ Donor ◽  
Organ Donors ◽  
Visual Aids ◽  
Next Of Kin ◽  
Critical Feature ◽  
Telephone Interviews ◽  
Donation Process

To examine how a family's understanding of brain death may affect the decision to donate, an interview study was conducted with the immediate next of kin of 164 medically suitable organ donor candidates. Telephone interviews were conducted with members of both donor and nondonor families 4 to 6 months after the relative's death. Only 61% of the donor and 53% of the nondonor respondents said they had received an explanation of brain death. Few respondents reported that the hospital or organ procurement organization staff used visual aids to clarify or reinforce the information they were given. Next of kin who decided against donation had far less understanding of brain death than did those who decided in favor of it. Before making an organ donation request, healthcare providers must inquire about and address common misunderstandings people have about brain death. Healthcare teams should develop and be trained on a clear protocol for communicating with the families of patients who may be potential organ donors.

Chaplain “DOs and DON’Ts” on Organ Donation

2018 ◽  
Vol 43 (7) ◽  
pp. 1-2
Author(s):  
Jozef Zalot ◽  
Keyword(s):  
Organ Donation ◽  
Organ Procurement ◽  
Family Members ◽  
Organ Donor ◽  
Organ Donors ◽  
Vital Organ ◽  
Course Of Action ◽  
Donation Process ◽  
Organ Procurement Organizations ◽  
The Relationship

This guide was developed in collaboration with LifeCenter Organ Donor Network (Cincinnati, OH) to offer chaplains a framework for the best possible course of action when they provide spiritual care to family members of patients who are potential vital organ donors. Some organ procurement organizations (OPOs) may want to control the donation process. They are thus hesitant to invite in—let alone collaborate with—any “outsiders” who they believe might undermine the likelihood of procuring vital organs. So how should a chaplain respond when ministering to potential vital organ donors and their families? Should they speak with family members about donation? What should they say? Do OPOs want chaplains to speak with family members? Should there be limits to these conversations? This can be a touchy area, because vital organ donation necessarily entails the death of the patient. This makes the relationship between chaplains and OPOs sometimes strained.

scholarly journals Organų donoro priežiūra intensyviosios terapijos skyriuje

2010 ◽  
Vol 8 (1) ◽  
pp. 0-0
Author(s):  
Viktorija Černiauskienė ◽  
Monika Čiplytė ◽  
Saulius Vosylius
Keyword(s):  
Intensive Care ◽  
Brain Death ◽  
Intensive Care Units ◽  
Care Management ◽  
Organ Procurement ◽  
Organ Donor ◽  
Organ Donors ◽  
Organ Donations ◽  
Vilnius University ◽  
Organ Donor Management

Viktorija Černiauskienė, Monika Čiplytė, Saulius VosyliusVilniaus universiteto Anesteziologijos ir reanimatologijos klinika, Vilniaus greitosios pagalbos universitetinė ligoninė,Šiltnamių g. 29, LT-04130 VilniusEl paštas: [email protected] Įvadas / tikslasDonorinių organų poreikis gerokai viršija atliktų organų transplantacijų skaičių. Dažniausios priežastys, dėl kurių potencialūs donorai netampa efektyviais donorais, yra donoro artimųjų prieštaravimas donorystei, medicininės kontraindikacijos, logistikos problemos, neadekvatus potencialių donorų gydymas iki eksplantacijos operacijos. Šio straipsnio tikslas yra apžvelgti naujausius medicinos mokslo laimėjimus atliekant potencialių organų donorų priežiūrą reanimacijos ir intensyviosios terapijos skyriuose. Metodai ir rezultataiIšliekant žymiam atotrūkiui tarp organų pasiūlos ir poreikio, būtina kuo efektyviau panaudoti esamus resursus, daugiau dėmesio skiriant tinkamai potencialaus organų donoro intensyviajai terapijai. Dėl smegenų mirties įvyksta sunkūs daugelio organizmui svarbių funkcijų sutrikimai: kraujotakos ir kvėpavimo sistemų, endokrininiai, elektrolitų balanso sutrikimai, hipotermija, koagulopatija ir intensyvus sisteminis uždegimo atsakas. IšvadosPasirinkta tinkama intensyviosios terapijos taktika galėtų padidinti transplantacijai tinkamų organų skaičių, išlaikyti geresnę jų funkciją po transplantacijos. Reikšminiai žodžiai: smegenų mirtis, intensyviosios terapijos skyriai, audinių ir organų donorystė, gairės Organ donor management in the intensive care unit Viktorija Černiauskienė, Monika Čiplytė, Saulius VosyliusClinic of Anaesthesiology and Intensive Care, Vilnius University,Šiltnamių Str. 29, LT-04130 Vilnius, LithuaniaE-mail: [email protected] Background / objectiveThe demand for donor organs greatly exceeds the number of transplantations. Many reasons may determine this inadequacy, such as family refusal, medical contraindications, logistics problems and inadequate management of the organ donor. The aim of the study was to present the recent achievements of medical practice in the management of organ donors in intensive care units. Methods and resultsWhile the discrepancy between the number of organ donations and transplantations persists, it is essential to use available resources more effectively, paying more attention to the intensive care management of the organ donor. Many physiological changes follow after brain death, such as cardiovascular and pulmonary dysfunction, endocrine and homeostasis disturbances, hypothermia, coagulopathy and an enhanced inflammatory response. ConclusionsOptimal intensive care could increase the number of organs available for transplantation and improve their function after it. Keywords: brain death, intensive care units, tissue and organ procurement, guidelines as topic

scholarly journals Lived Experiences of Iranian Nurses Caring for Brain Death Organ Donor Patients: Caring as “Halo of Ambiguity and Doubt”

2015 ◽  
Vol 8 (7) ◽  
pp. 281 ◽  
Author(s):  
Zahra Keshtkaran ◽  
Farkhondeh Sharif ◽  
Elham Navab ◽  
Sakineh Gholamzadeh
Keyword(s):  
Brain Death ◽  
Thematic Analysis ◽  
Lived Experiences ◽  
Organ Donor ◽  
Organ Donors ◽  
Structured Interviews ◽  
Supportive Services ◽  
Care Giving ◽  
The Given ◽  
The Brain

<p><strong>BACKGROUND: </strong>Brain death is a concept in which its criteria have been expressed as documentations in Harvard Committee of Brain Death. The various perceptions of caregiver nurses for brain death patients may have effect on the chance of converting potential donors into actual organ donors.</p><p>Objective: The present study has been conducted in order to perceive the experiences of nurses in care-giving to the brain death of organ donor patients.</p><p><strong>METHODS:</strong> This qualitative study was carried out by means of Heidegger’s hermeneutic phenomenology. Eight nurses who have been working in ICU were interviewed. The semi-structured interviews were recorded bya tape-recorder and the given texts were transcribed and the analyses were done by Van-Mannen methodology and (thematic) analysis.</p><p><strong>RESULTS: </strong>One of the foremost themes extracted from this study included ‘Halo of ambiguity and doubt’ that comprised of two sub-themes of ‘having unreasonable hope’ and ‘Conservative acceptance of brain death’. The unreasonable hope included lack of trust (uncertainty) in diagnosis and verification of brain death, passing through denial wall, and avoidance from explicit and direct disclosure of brain death in patients’ family. In this investigation, the nurses were involved in a type of ambiguity and doubt in care-giving to the potentially brain death of organ donor patients, which were also evident in their interaction with patients’ family and for this reason, they did not definitely announce the brain death and so far they hoped for treatment of the given patient. Such confusion and hesitance both caused annoyance of nurses and strengthening the denial of patients’ family to be exposed to death.</p><p><strong>CONCLUSION:</strong> The results of this study reveal the fundamental perceived care-giving of brain death in organ donor patients and led to developing some strategies to improve care-giving and achievement in donation of the given organ and necessity for presentation of educational and supportive services for nurses might become more evident than ever.</p>

scholarly journals Perfil epidemiológico, disfunção orgânica e eletrolítica em potenciais doadores de órgãos e tecidos de um hospital do sul do Brasil / Epidemiological profile, organic and electrolytic dysfunction in potential donors of organs and tissues of a hospital of the south of Brazil

2019 ◽  
Vol 64 (2) ◽  
pp. 100
Author(s):  
Kelser De Souza Kock ◽  
Mariana Gabriela Santana ◽  
Silvia Catarine Da Silva ◽  
Samuel Brida Andrade ◽  
Edvan Nunes dos Santos
Keyword(s):  
Brain Death ◽  
Organ Procurement ◽  
Organ Donors ◽  
Santa Catarina ◽  
Cross Sectional ◽  
Southern State ◽  
Terapia Intensiva ◽  
South Of Brazil ◽  
Epidemiological Profile ◽  
Metabolic Dysfunctions

Objetivo: Analisar o perfil epidemiológico e as disfunções orgânicas e eletrolíticas em potenciais doadores de órgãos. Métodos: Estudo transversal, descritivo. Foram selecionados pacientes com morte encefálica, na Unidade de Terapia Intensiva de um hospital do sul do estado de Santa Catarina, no período de 2014 a 2016. Resultados: Foram avaliados 64 indivíduos, com prevalência do sexo masculino (56,3%), com mediana de 51,5 anos de idade. O Acidente Vascular Cerebral mostrou-se como a principal causa de diagnóstico de morte encefálica, em 42% dos casos. Houve doação em 45% dos pacientes, totalizando 120 órgãos ou tecidos doados, destacando-se o globo ocular, os rins e o fígado. Nos exames laboratoriais os pacientes apresentaram uma mediana de 147,0 mmol/L para o sódio, 4,2 mmol/L para o potássio e 246,0 mg/dL para a glicose. O escore de SOFA apresentou mediana geral 6, com maiores valores nos SOFA cardiovascular e respiratório (p<0,001) em relação aos SOFA renal, hematológico e hepático. Conclusão: O perfil epidemiológico dos potenciais doadores é similar a outros estudos. Quanto às disfunções orgânicas eletrolíticas e metabólicas, foram evidenciados distúrbios de hipernatremia e hiperglicemia. As disfunções orgânicas significativas identificadas pelo SOFA foram nos sistemas cardiovascular e respiratório. Neste sentido, especial atenção deve ser dada a estes sistemas para adequada manutenção do potencial doador.Descritores: Morte encefálica, Obtenção de tecidos e órgãos, Eletrólitos, Escores de disfunção orgânicaABSTRACT:Objective: To analyze the epidemiological profile and the organ and electrolytics dysfunctions in potential organ donors. Methods: Cross-sectional, descriptive study. We selected patients with brain death at the Intensive Care Unit of a hospital in the southern state of Santa Catarina, from 2014 to 2016. Results: We evaluated sixty-six individuals, with a prevalence of males (56.3%), with a median age of 51.5 years. The Cerebral Vascular Accident was the main cause of brain death’s diagnosis (42%). There was donation in 45% of the patients, totaling 120 organs and tissue donated, standing out the eyeball, kidneys and liver. In the laboratory tests the patients had a median of 147.0 mmol / L for sodium, 4.2 mmol / L for potassium and 246.0 mg / dL for glucose. The SOFA score presented general median 6, with higher values in cardiovascular and respiratory SOFA (p <0.001) in relation to renal, hematological and hepatic SOFA. Conclusion: The epidemiological profile of potential donors is similar to other studies. As for the organic and metabolic dysfunctions, disorders of hypernatremia and hyperglycemia were evidenced. The significant organic dysfunctions identified by SOFA were in the cardiovascular and respiratory systems. In this sense, special attention should be given to these systems for adequate maintenance of the potential donor.Keywords: Brain death, Tissue and organ procurement, Electrolytes, Organ dysfunction scores

THE BIOPHILOSOPHICAL BASIS OF WHOLE-BRAIN DEATH

2002 ◽  
Vol 19 (2) ◽  
pp. 324-342 ◽  
Author(s):  
James L. Bernat
Keyword(s):  
Brain Death ◽  
Animal Species ◽  
Organ Procurement ◽  
Organ Donor ◽  
Multiple Organ ◽  
Human Organism ◽  
Whole Brain ◽  
Whole Brain Death ◽  
Correct Understanding ◽  
Biological Representation

Notwithstanding these wise pronouncements, my project here is to characterize the biological phenomenon of death of the higher animal species, such as vertebrates. My claim is that the formulation of “whole-brain death” provides the most congruent map for our correct understanding of the concept of death. This essay builds upon the foundation my colleagues and I have laid since 1981 to characterize the concept of death and refine when this event occurs. Although our society's well-accepted program of multiple organ procurement for transplantation requires the organ donor first to be dead, the concept of brain death is not merely a social contrivance to permit us to obtain the benefits of organ procurement. Rather, the concept of whole-brain death stands independently as the most accurate biological representation of the demise of the human organism.

Hemodynamic Monitoring of Organ Donors: A Novel Use of the Esophageal Echo-Doppler Probe

2006 ◽  
Vol 72 (6) ◽  
pp. 500-504 ◽  
Author(s):  
James Cipolla ◽  
Stanislaw Stawicki ◽  
Deneen Spatz
Keyword(s):  
Hemodynamic Monitoring ◽  
Organ Procurement ◽  
Organ Donor ◽  
Clinical Settings ◽  
Organ Donors ◽  
Critical Care Nursing ◽  
Doppler Probe ◽  
Esophageal Doppler Monitoring ◽  
Potential Benefits ◽  
Care Nursing

The esophageal Doppler monitoring (EDM) technology is well described in the literature. As it evolved over the last several years, the use of EDM has found expanded indications in various clinical settings. One of the areas where EDM has not been studied extensively is its use during optimization of organ donors before organ procurement. Close hemodynamic monitoring has become essential in the era of increasing use of extended organ donors. We present six cases of successful EDM use during preorgan procurement resuscitation of organ donors. Despite labile hemodynamics in the majority of these cases, EDM-guided optimization of resuscitative end-points allowed successful organ procurements and transplants, including 12 kidneys, 6 livers, 3 hearts, 2 pancreases, and 2 lungs. The EDM technology is noninvasive, technically easy, and less expensive than the traditional pulmonary artery catheter. Other potential benefits of the EDM include its portability and possibility of deployment in any setting by trained organ procurement personnel or critical care nursing staff. In conclusion, successful organ procurement can be facilitated by the use of EDM technology in hemodynamically labile organ donor patients.

A Qualitative Study of Turning Points or Aha! Moments in Older Adults’ Discussions About Organ Donation

2018 ◽  
Vol 28 (3) ◽  
pp. 207-212 ◽  
Author(s):  
Kimberly Downing ◽  
Linda L. Jones
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Organ Donation ◽  
Organ Procurement ◽  
Turning Points ◽  
Age Groups ◽  
Organ Donor ◽  
Younger Age ◽  
Donation Process ◽  
Dialogue Process

Introduction: Older adults (50-70 years old) have lower organ donor registration rates than younger adults. Older adults have different informational needs and donor registration behavior than younger age groups. Objective: The objective of this qualitative study was to understand insights of older adults about organ donation to effectively address the barriers to becoming an organ donor. This study identified turning points as “Aha!” moments that occurred during a dialogue intervention where older adults discussed benefits, barriers, and process to organ donation. Setting and Participants: Dialogues were held with small groups of older adults in 11 communities in a Midwestern organ procurement organization service area. Participants were positive to organ donation, but not registered as an organ donor. Methods/Approach: Qualitative analysis of verbatim comments from the dialogue and a follow-up survey were used to examine turning points or “Aha!” moments of participants’ decision-making about organ donation and organ donor registration. Findings: Twenty-one separate in-depth dialogues were conducted with 198 participants, with mean age of 60.57 years. There were 2757 separate comments coded with 465 of the comments (17%) identified as providing Aha! moments during the dialogue. Three themes include benefits of organ donation (30%), barriers about organ donation (39%), and organ donation process (31%). Discussion: The research identified moments in the dialogue where possible learning about organ donation may have occurred. After participation in the dialogue process, there was an increase in intent to register to be an organ donor, organ donation discussion with family and friends, and organ donor registration.

Transparent Vessels?: What Organ Donors Should Be Allowed to Know about Their Recipients

2013 ◽  
Vol 41 (1) ◽  
pp. 323-332
Author(s):  
Richard H. Dees
Keyword(s):  
Consensus Statement ◽  
Organ Donor ◽  
Hiv Positive ◽  
Organ Donors ◽  
Live Donor ◽  
Transplant Center ◽  
Donation Process ◽  
Pertinent Information ◽  
Risk And Benefit

After a long search, Jonathan has finally found someone willing to donate a kidney to him and thereby free him from dialysis. Meredith is Jonathan's second cousin, and she considers herself a generous person, so although she barely knows Jonathan, she is willing to help. However, as Meredith learns more about the donation process, she begins to ask questions about Jonathan: “Is he HIV positive? I heard he got it using drugs. Has he been in jail? He's already had one live donor, so what happened to the first kidney? Did he forget to take his drugs or something?” The transplant center must, then, decide if Meredith is, in fact, entitled to answers to these kinds of questions. According to the Consensus Statement on the Live Organ Donor, “It is incumbent on the transplant center to provide full and accurate disclosure to potential donors of all pertinent information regarding risk and benefit to the donor and recipient.” But whether answers to the Meredith's questions count as “pertinent information regarding the risk and benefit” is the issue at hand.

How nurses shift from care of a brain-injured patient to maintenance of a brain-dead organ donor

2001 ◽  
Vol 10 (5) ◽  
pp. 306-312 ◽  
Author(s):  
L Day
Keyword(s):  
Critical Care ◽  
Organ Procurement ◽  
Injured Patient ◽  
Organ Donor ◽  
Critical Care Nurses ◽  
Organ Donors ◽  
Early Referral ◽  
Brain Injured Patient ◽  
Brain Injured ◽  
Brain Dead

BACKGROUND: The responsibility of obtaining organs for transplantation rests partly on critical care nurses. How nurses balance care of critically ill, brain-injured patients with the professional responsibility to procure organs is a question of ethical and clinical importance. OBJECTIVES: To describe the experiences of critical care nurses in making the shift from caring for a brain-injured patient identified as a potential organ donor to maintaining a brain-dead body. METHODS: An interpretive, phenomenological design was used. In 2 trauma centers, 9 critical care nurses were interviewed, and 2 of the 9 nurses were observed. RESULTS: Identification of potential organ donors is made under conditions of prognostic ambiguity. The transition from brain injury to brain death is a period of instability in which the critical care team must decide quickly whether to resuscitate a patient in order to procure organs. After a patient is brain dead, critical care nurses' relationship with and responsibility toward the patient change. CONCLUSIONS: The process of identifying potential organ donors and holding open the tentative possibility of organ procurement illustrates the practical difficulties of early referral of potential donors to organ procurement organizations. Early referral to an organ procurement organization implies a commitment to organ procurement that some nurses may hesitate to make because such a commitment changes their relationship with a brain-injured patient.

Explaining brain death: a critical feature of the donation process

1997 ◽  
Vol 7 (1) ◽  
pp. 14-21 ◽  
Author(s):  
Holly Franz ◽  
William DeJong ◽  
Susan Wolfe ◽  
Howard BS ◽  
Denise RN ◽  
...  
Keyword(s):  
Brain Death ◽  
Critical Feature ◽  
Donation Process
Sign in / Sign up

Export Citation Format

Share Document