scholarly journals Time for determining the diagnosis of brain death and its relation to organ donation

10.3823/2358 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Ingrid Gurgel Amorim ◽  
Ana Elza Oliveira De Mendonça ◽  
Izaura Luzia Silvério Freire ◽  
Thaiza Teixeira Xavier Nobre ◽  
Raysa Da Silva Dantas ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Brain Death ◽  
Organ Donation ◽  
Key Words ◽  
Key Words Brain ◽  
Tissue Donation ◽  
Brain Death Diagnosis ◽  
Death Time ◽  
Donation Process ◽  
Quantitative Descriptive

This study aimed to identify the time needed for confirmation of brain death and its relation to organ donation. Quantitative, descriptive and retrospective study with 175 patients who had diagnosis of brain death completed between January and December 2013. The time from 11 to 20 hours (38.9%) prevailed, with average of 17.91 hours (SD 17.53). There was significant association between the finding of brain death diagnosis in less than 20 hours and the number of donated livers (P = 0.041). We stress the importance of speeding up the diagnosis of brain death as an important step of the donation process, in order to contribute to realization of transplants. Key words: Brain Death; Time; Directed Tissue Donation; Nursing.  

Family perspectives on organ and tissue donation for transplantation: A principlist analysis

2017 ◽  
Vol 25 (8) ◽  
pp. 1041-1050
Author(s):  
Marcelo José dos Santos ◽  
Lydia Feito
Keyword(s):  
Organ Donation ◽  
Organ Procurement ◽  
Sao Paulo ◽  
Tissue Donation ◽  
São Paulo ◽  
Ethical Considerations ◽  
Donation Process ◽  
The Family ◽  
Organ Procurement Organizations ◽  
Family Interview

Background: The family interview context is permeated by numerous ethical issues which may generate conflicts and impact on organ donation process. Objective: This study aims to analyze the family interview process with a focus on principlist bioethics. Method: This exploratory, descriptive study uses a qualitative approach. The speeches were collected using the following prompt: “Talk about the family interview for the donation of organs and tissues for transplantation, from the preparation for the interview to the decision of the family to donate or not.” For the treatment of qualitative data, we chose the method of content analysis and categorical thematic analysis. Participants: The study involved 18 nurses who worked in three municipal organ procurement organizations in São Paulo, Brazil, and who conducted family interviews for organ donation. Ethical considerations: The data were collected after approval of the study by the Research Ethics Committee of the School of Nursing of the University of São Paulo. Results: The results were classified into four categories and three subcategories. The categories are the principles adopted by principlist bioethics. Discussion: The principles of autonomy, beneficence, non-maleficence, and justice permeate the family interview and reveal their importance in the organs and tissues donation process for transplantation. Conclusion: The analysis of family interviews for the donation of organs and tissues for transplantation with a focus on principlist bioethics indicates that the process involves many ethical considerations. The elucidation of these aspects contributes to the discussion, training, and improvement of professionals, whether nurses or not, who work in organ procurement organizations and can improve the curriculum of existing training programs for transplant coordinators who pursue ethics in donation and transplantation as their foundation.

Increasing Referrals and Donations Using the Transplant Center Development Model

1996 ◽  
Vol 6 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Mark T Gravel ◽  
Penelope Szeman
Keyword(s):  
Organ Donation ◽  
Organ Procurement ◽  
Medical Center ◽  
Development Model ◽  
Tissue Donation ◽  
Staff Education ◽  
Organ Procurement Organization ◽  
Organ And Tissue Donation ◽  
Transplant Center ◽  
Donation Process

Although transplantation centers directly benefit from organ and tissue donation, they continue to yield low organ and tissue referral and donation rates. Our medical center and organ procurement organization developed a model to increase referral and donation rates. This model, called the Transplant Center Development Model, facilitates the donation process, specializes staff education, and promotes administrative involvement. After it was was implemented at our medical center in 1991, the referral and donation rates from 1988 to 1990 were compared with those from 1991 to 1993. The results showed that after implementation of the model, the organ referral mean increased 47%; the organ donation mean, 50%; and the tissue donation mean, 117%. These findings suggest that this model may be a valuable tool in transplant center development.

scholarly journals Attitude of Healthcare Professionals: A Major Limiting Factor in Organ Donation from Brain-Dead Donors

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Maciej Kosieradzki ◽  
Anna Jakubowska-Winecka ◽  
Michal Feliksiak ◽  
Ilona Kawalec ◽  
Ewa Zawilinska ◽  
...  
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Intensive Therapy ◽  
Clinical Signs ◽  
Deceased Donor ◽  
Limiting Factor ◽  
Brain Death Diagnosis ◽  
Donation Rate ◽  
Organ Recovery ◽  
Donation Activity

Public attitude toward deceased donor organ recovery in Poland is quite positive, with only 15% opposing to donation of their own organs, yet actual donation rate is only 16/pmp. Moreover, donation rate varies greatly (from 5 to 28 pmp) in different regions of the country. To identify the barriers of organ donation, we surveyed 587 physicians involved in brain death diagnosis from regions with low (LDR) and high donation rates (HDR). Physicians from LDR were twice more reluctant to start diagnostic procedure when clinical signs of brain death were present (14% versus 5.5% physicians from HDR who would not diagnose death, resp.). Twenty-five percent of LDR physicians (as opposed to 12% of physicians from HDR) would either continue with intensive therapy or confirm brain death and limit to the so-called minimal therapy. Only 32% of LDR physicians would proceed with brain death diagnosis regardless of organ donation, compared to 67% in HDR. When donation was not an option, mechanical ventilation would be continued more often in LDR regions (43% versus 26.7%;P<0.01). In conclusion, low donation activity seems to be mostly due to medical staff attitude.

scholarly journals Retrospective Analysis of Brain Death Cases

2021 ◽  
Author(s):  
Özlem Özkan Kuşcu ◽  
Meltem Aktay
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Brain Death ◽  
Organ Donation ◽  
Death Time ◽  
The Family ◽  
The Mean ◽  
End Stage ◽  
Cadaveric Donors ◽  
Death Cases

Objective: Organ transplantation is important for patients with end-stage organ failure to survive. For this reason, detection of brain death cases and adequate number of donations are necessary. Methods: 31 cases diagnosed with brain death between 01.01.2018-01.01.2020 were evaluated retrospectively. Demographic characteristics, diagnoses causing brain death, time to detect brain death, additional tests applied for the diagnosis of brain death, time to diagnosis of brain death and cardiopulmonary arrest or donation, the proportion of families accepting organ donation, the proportion of donors, organ removed from donors the number and blood types of the cases were recorded Results: The number of cases diagnosed with brain death was 31, and the mean age of the cases was 46,71 (1-89) years. 71% (n=22) of the patients were admitted to the intensive care unit from the emergency department. The most common reason for admission to the intensive care unit 67.7% (n=21) was intracranial bleeding. While the family donation rate was 19% (n=5), three cases who accepted the donation could be donors. The mean age of the patients for whom organ donation was accepted was 35.80±11 years, while the mean age of the patients for whom organ donation was not accepted was 57.43±21.30 years (p=0.04). Conclusion: Due to the increasing number of end-stage organ failure patients awaiting transplantation, it is necessary to increase the number of cadaveric donors. Timely and sufficient detection of brain death cases, increasing the family donation rate and increasing the number of cadaveric donors will be contributed.

scholarly journals Five-Year Experience on Patients with Brain Death Diagnosis: A Two-Centered Retrospective Study

2020 ◽  
Vol 25 (1) ◽  
pp. 109-113
Author(s):  
Okan Andıc ◽  
Hilmi Demirkiran ◽  
Ilhan Bahar ◽  
Arzu Esen Tekeli ◽  
Nurcin Gülhas
Keyword(s):  
Retrospective Study ◽  
Brain Death ◽  
Brain Death Diagnosis

Readiness of critical care physicians and nurses to handle requests for organ donation

1998 ◽  
Vol 7 (1) ◽  
pp. 4-12 ◽  
Author(s):  
MJ Evanisko ◽  
CL Beasley ◽  
LE Brigham ◽  
C Capossela ◽  
GR Cosgrove ◽  
...  
Keyword(s):  
Critical Care ◽  
Brain Death ◽  
Organ Donation ◽  
The United States ◽  
Critical Care Nurses ◽  
Care Staff ◽  
Factual Knowledge ◽  
Donation Process ◽  
Nurses And Physicians ◽  
Effective Procedures

BACKGROUND: Critical care nurses and physicians usually care for those patients whose condition progresses to brain death and are also often responsible for requesting organ donation from the family of a brain-dead patient. We hypothesized that staff support, knowledge, and training levels would be significantly associated with organ donation rates. OBJECTIVE: To assess the readiness of critical care staff to successfully handle requests for organ donation. METHODS: A total of 1061 critical care staff from 28 hospitals in four separate regions of the United States completed a questionnaire that assessed (1) factual knowledge about organ donation, (2) understanding of brain death, (3) previous training in procedures for requesting donations, and (4) comfort levels with the donation process. RESULTS: Staff training in effective procedures for requesting organ donations was significantly correlated with hospitals' donation rates. Less than a third of respondents, however, had received training in explaining brain death to and requesting organ donation from a grieving family. In hospitals with high rates of organ donation, 52.9% of staff had received training; in hospitals with low rates of organ donation, 23.5% of staff had received training. Levels of factual knowledge about organ donation and brain death were unexpectedly low but were not significantly related to hospitals' rates of organ donation. CONCLUSIONS: Training of critical care nurses and physicians in effective procedures for requesting organ donation is significantly associated with higher rates of organ donation, yet two thirds of critical care staff report no relevant training. Consequently, critical care staff cannot be considered ready to effectively handle requests for organ donation.

scholarly journals Intensive care practices in brain death diagnosis and organ donation

Anaesthesia ◽  
2015 ◽  
Vol 70 (10) ◽  
pp. 1130-1139 ◽  
Author(s):  
D. Escudero ◽  
M. O. Valentín ◽  
J. L. Escalante ◽  
A. Sanmartín ◽  
M. Perez-Basterrechea ◽  
...  
Keyword(s):  
Intensive Care ◽  
Brain Death ◽  
Organ Donation ◽  
Brain Death Diagnosis ◽  
Care Practices

Donation Education for Medical Students: Enhancing the Link between Physicians and Procurement Professionals

2005 ◽  
Vol 15 (2) ◽  
pp. 124-128 ◽  
Author(s):  
Christian C. Essman ◽  
Daniel J. Lebovitz
Keyword(s):  
Medical Students ◽  
Organ Donation ◽  
Ethical Issues ◽  
Organ Procurement ◽  
Tissue Donation ◽  
Current Crisis ◽  
Educational Approach ◽  
Organ And Tissue Donation ◽  
Donation Process ◽  
Organ Procurement Organizations

Purpose Increasing healthcare professionals' knowledge about organ and tissue donation; the national mandates regarding referral compliance; and the effect on donors, donor families, and transplant recipients is a challenging task. Physicians not routinely involved in organ donation or transplantation are some of the most difficult professionals for organ procurement organizations to access. A course for medical students was developed to initiate the transfer of information, comfort, and familiarity with the organ and tissue donation process. Methods Discussions with a local medical school revealed that little organized education on organ and tissue donation existed. An elective course was developed consisting of 2-hour lectures, once a week for 6 weeks. Topics included an overview of tissue and organ donation, history and significance of the current crisis, determination of brain death and its role in organ donation, tissue donation, pretransplant and posttransplant processes, ethical issues, and the donor family and recipient experience. Results A thorough course proposal was presented to the medical school's Chairman of Surgery and Chairman of Transplantation. The proposal was approved for first- and second-year medical students. Conclusion Offering medical students a unique and comprehensive course may attract curious students who could become future champions for donation. This type of educational approach may significantly influence future interactions between physicians and organ procurement organizations. If more organ procurement organizations implement this type of program, the medical students' knowledge of donation will not only affect and benefit the local organ procurement organization's service area but other procurement organizations throughout the country as well.

scholarly journals Selective 4 Vessels Angiography in Brain Death: A Retrospective Study

2010 ◽  
Vol 37 (4) ◽  
pp. 492-497 ◽  
Author(s):  
Martin Savard ◽  
Alexis F. Turgeon ◽  
Jean-Luc Gariépy ◽  
François Trottier ◽  
Stephan Langevin
Keyword(s):  
Retrospective Study ◽  
Brain Death ◽  
Circulatory Arrest ◽  
Venous Drainage ◽  
Arterial Blood Flow ◽  
Clinical Practices ◽  
Brain Death Diagnosis ◽  
Arterial Blood ◽  
Cerebral Circulatory Arrest ◽  
Study Population

Background:In Canada, ancillary tests, such as selective four vessels angiography (S4VA), are sometimes necessary for brain death (BD) diagnosis when the clinical exam cannot be completed or confounding factors are present. Recent Canadian guidelines assert that brain death is supported by the absence of arterial blood flow at the surface of the brain and that venous return should not be considered. However, neuropathologic and angiographic studies have suggested that arteries might still be patent in BD patients. Current clinical practices in BD diagnosis following S4VA need to be better understood.Methods:We conducted a retrospective study of all S4VA performed for the determination of BD in a level 1 NeuroTrauma centre from 2003 to 2007. The objective of the study was to describe the prevalence of intracranial arterial, capillary (parenchymogram) and venous opacification in our study population. All tests were reviewed independently by two neuroradiologists. Disagreements were resolved by consensus.Results:Thirty two patients were declared BD following S4VA during the study period. Nine of these patients (28%) presented some proximal opacification of intracranial arteries (95% CI 15-45%). As opposed, none had a cerebral capillary and deep venous drainage opacification (95% CI 0-10%).Conclusion:The absence of cerebral deep venous drainage or parenchymogram might represent a better objective marker of cerebral circulatory arrest for brain death diagnosis when the use of S4VA is required. These findings open the path for further research in enhancing our interpretation of angiographic studies for brain death diagnosis.

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