scholarly journals The Legal Determination of Brain Death and Organ Donation for Neurosurgeons

2018 ◽  
Vol 27 (5) ◽  
pp. 375-379
Author(s):  
Yoshihiro Natori
Keyword(s):  
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.


Author(s):  
W. I. Steudel ◽  
F. Kreth ◽  
R. Lorenz ◽  
A. Fürsch ◽  
W. Faßbinder ◽  
...  
Keyword(s):  

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.


2017 ◽  
Vol 101 ◽  
pp. S134
Author(s):  
Türkan Yilmaz Ulusoy ◽  
Müjgan Öztürk ◽  
Yasemin Berkant
Keyword(s):  

Author(s):  
Eelco F.M. Wijdicks

There are clear guiding principles in the determination of brain death and subsequent discussion about organ donation. In most situations, brain death is straightforward to diagnose, consent is obtained for organ donation, and—for the endlessly waiting recipients—all goes well. But questions can arise, and occasionally physicians encounter problems. Advances in medical practice have also changed the way physicians approach catastrophic neurological illness, and the consequences of therapeutic interventions must be considered. The number of available ancillary tests also has increased over the years, creating difficulties with interpretation when the validity of the tests is insufficiently known. The diagnosis of brain death also may generate moral dilemmas. This chapter seeks to address solutions to common clinical problems in practice.


Author(s):  
Eelco F.M. Wijdicks

Chapter 6 discusses the clinical problems faced in the assessment and determination of brain death, and the subsequent discussion about organ donation.


2021 ◽  
Vol 23 (2) ◽  
pp. 211-214
Author(s):  
Meghan K Bowtell ◽  
◽  
Melissa J Ankravs ◽  
Timothy Fazio ◽  
Jeffrey J Presneill ◽  
...  

OBJECTIVE: The cost of providing care in an intensive care unit (ICU) after brain death to facilitate organ donation is unknown. The objective of this study was to estimate expenditure for the care delivered in the ICU between the diagnosis of brain death and subsequent organ donation. DESIGN: Cohort study of direct and indirect costs using bottom-up and top-down microcosting techniques. SETTING: Single adult ICU in Australia. PARTICIPANTS: All patients who met criteria for brain death and proceeded to organ donation during a 13-month period between 1 January 2018 and 31 January 2019. MAIN OUTCOME MEASURES: A comprehensive cost estimate for care provided in the ICU from determination of brain death to transfer to theatre for organ donation. RESULTS: Forty-five patients with brain death became organ donors during the study period. The mean duration of post-death care in the ICU was 37.9 hours (standard deviation [SD], 16.5) at a mean total cost of $7520 (SD, $3136) per donor. ICU staff salaries were the greatest contributor to total costs, accounting for a median proportion of 0.72 of total expenditure (interquartile range, 0.68–0.75). CONCLUSIONS: Substantial costs are incurred in ICU for the provision of patient care in the interval between brain death and organ donation.


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