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. 2018 Nov 16;22(1):306.
doi: 10.1186/s13054-018-2241-4.

Brain death and postmortem organ donation: report of a questionnaire from the CENTER-TBI study

Ernest van Veen  1   2   3 , Mathieu van der Jagt  1 , Maryse C Cnossen  2 , Andrew I R Maas  4 , Inez D de Beaufort  3 , David K Menon  5 , Giuseppe Citerio  6   7 , Nino Stocchetti  8   9 , Wim J R Rietdijk  1 , Jeroen T J M van Dijck  10 , Erwin J O Kompanje  11   12 ; CENTER-TBI investigators and participants
Collaborators, Affiliations

Brain death and postmortem organ donation: report of a questionnaire from the CENTER-TBI study

Ernest van Veen et al. Crit Care. .

Abstract

Background: We aimed to investigate the extent of the agreement on practices around brain death and postmortem organ donation.

Methods: Investigators from 67 Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study centers completed several questionnaires (response rate: 99%).

Results: Regarding 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.

Conclusions: This 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.

Keywords: Brain death; Ethics; Postmortem organ donation; Traumatic brain injury; Ventricular drainage; Withdrawing life-sustaining measures.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable since no patients participated, and the centers have given consent by completing the questionnaire.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Results of question 13 (Questionnaire 8): Would you consider organ donation after circulatory arrest in a patient in whom mechanical ventilation will be withdrawn, but who is not brain dead?
Fig. 2
Fig. 2
Results of question 9 (Questionnaire 8): If the decision is made to withdraw life-sustaining measures, in a patient with high intracranial pressure, but who is not brain dead, would you remove the ventricular drain (for CSF drainage), but continue other life-sustaining measures in the hope that the patient will become brain dead and thereby becomes a suitable candidate for organ donation?
See this image and copyright information in PMC

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