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.
| Original language | English (US) |
|---|---|
| Article number | 306 |
| Journal | Critical Care |
| Volume | 22 |
| Issue number | 1 |
| DOIs | |
| State | Published - Nov 16 2018 |
Keywords
- Brain death
- Ethics
- Postmortem organ donation
- Traumatic brain injury
- Ventricular drainage
- Withdrawing life-sustaining measures
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine
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Brain death and postmortem organ donation : Report of a questionnaire from the CENTER-TBI study. / Van Veen, Ernest; Van Der Jagt, Mathieu; Cnossen, Maryse C. et al.
In: Critical Care, Vol. 22, No. 1, 306, 16.11.2018.Research output: Contribution to journal › Article › peer-review
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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 - Ackerlund, Cecilia
AU - Adams, Hadie
AU - Agnoletti, Vanni
AU - Allanson, Judith
AU - Amrein, Krisztina
AU - Andaluz, Norberto
AU - Andelic, Nada
AU - Andreassen, Lasse
AU - Antun, Azasevac
AU - Anke, Audny
AU - Antoni, Anna
AU - Ardon, Hilko
AU - Audibert, Gérard
AU - Auslands, Kaspars
AU - Azouvi, Philippe
AU - Azzolini, Maria Luisa
AU - Baciu, Camelia
AU - Badenes, Rafael
AU - Bartels, Ronald
AU - Barzó, Pál
AU - Bauerfeind, Ursula
AU - Beauvais, Romuald
AU - Beer, Ronny
AU - Francisco, Javier Belda
AU - Bellander, Bo Michael
AU - Belli, Antonio
AU - Bellier, Rémy
AU - Benali, Habib
AU - Benard, Thierry
AU - Berardino, Maurizio
AU - Beretta, Luigi
AU - Beynon, Christopher
AU - Bilotta, Federico
AU - Binder, Harald
AU - Biqiri, Erta
AU - Blaabjerg, Morten
AU - Den Boogert, Hugo
AU - Bouzat, Pierre
AU - Bragge, Peter
AU - Brazinova, Alexandra
AU - Brinck, Vibeke
AU - Brooker, Joanne
AU - Brorsson, Camilla
AU - Buki, Andras
AU - Bullinger, Monika
AU - Calappi, Emiliana
AU - Calvi, Maria Rosa
AU - Cameron, Peter
AU - Lozano, Guillermo Carbayo
AU - Carbonara, Marco
AU - Carise, Elsa
AU - Carpenter, K.
AU - Castaño-León, Ana M.
AU - Causin, Francesco
AU - Chevallard, Giorgio
AU - Chieregato, Arturo
AU - Coburn, Mark
AU - Coles, Jonathan
AU - Coles-Kemp, Lizzie
AU - Collett, Johnny
AU - Cooper, Jamie D.
AU - Correia, Marta
AU - Covic, Amra
AU - Curry, Nicola
AU - Czeiter, Endre
AU - Czosnyka, Marek
AU - Dahyot-Fizelier, Claire
AU - Damas, François
AU - Damas, Pierre
AU - Dawes, Helen
AU - De Keyser, Véronique
AU - Della Corte, Francesco
AU - Depreitere, Bart
AU - De Ruiter Godard, C. W.
AU - Dilvesi, Dula
AU - Ding, Shenghao
AU - Dippel, Diederik
AU - Dixit, Abhishek
AU - Donoghue, Emma
AU - Dreier, Jens
AU - Dulière, Guy Loup
AU - Eapen, George
AU - Engemann, Heiko
AU - Ercole, Ari
AU - Esser, Patrick
AU - Ezer, Erzsébet
AU - Fabricius, Martin
AU - Feigin, Valery L.
AU - Feng, Junfeng
AU - Foks, Kelly
AU - Fossi, Francesca
AU - Francony, Gilles
AU - Freo, Ulderico
AU - Frisvold, Shirin
AU - Furmanov, Alex
AU - Gagliardo, Pablo
AU - Galanaud, Damien
AU - Gantner, Dashiell
AU - Gao, Guoyi
AU - Geleijns, Karin
AU - George, Pradeep
AU - Ghuysen, Alexandre
AU - Giga, Lelde
AU - Giraud, Benoit
AU - Glocker, Ben
AU - Golubovic, Jagos
AU - Gomez, Pedro A.
AU - Grossi, Francesca
AU - Gruen, Russell L.
AU - Gupta, Deepak
AU - Haagsma, Juanita A.
AU - Haitsma, Iain
AU - Hartings, Jed A.
AU - Helbok, Raimund
AU - Helseth, Eirik
AU - Hertle, Daniel
AU - Hoedemaekers, Astrid
AU - Hoefer, Stefan
AU - Horton, Lindsay
AU - Huijben, Jilske
AU - Hutchinson, Peter J.
AU - Håberg, Asta Kristine
AU - Jacobs, Bram
AU - Jankowski, Stefan
AU - Jarrett, Mike
AU - Jelaca, Bojan
AU - Jiang, Ji Yao
AU - Jones, Kelly
AU - Kamnitsas, Konstantinos
AU - Karan, Mladen
AU - Katila, Ari
AU - Kaukonen, Maija
AU - Kerforne, Thomas
AU - Kivisaari, Riku
AU - Kolias, Angelos G.
AU - Kolumbán, Bálint
AU - Kolundzija, Ksenija
AU - Kondziella, Daniel
AU - Koskinen, Lars Owe
AU - Kovács, Noémi
AU - Lagares, Alfonso
AU - Lanyon, Linda
AU - Laureys, Steven
AU - Lecky, Fiona
AU - Ledig, Christian
AU - Lefering, Rolf
AU - Legrand, Valerie
AU - Lei, Jin
AU - Levi, Leon
AU - Lightfoot, Roger
AU - Lingsma, Hester
AU - Loeckx, Dirk
AU - Lozano, Angels
AU - MacDonald, Stephen
AU - Maegele, Marc
AU - Majdan, Marek
AU - Major, Sebastian
AU - Manara, Alex
AU - Manley, Geoffrey
AU - Didier, Martin
AU - Martin, Leon Francisco
AU - Martino, Costanza
AU - Maruenda, Armando
AU - Maréchal, Hugues
AU - Masala, Alessandro
AU - Mattern, Julia
AU - McFadyen, Charles
AU - McMahon, Catherine
AU - Melegh, Béla
AU - Menovsky, Tomas
AU - Morganti-Kossmann, Cristina
AU - Mulazzi, Davide
AU - Muraleedharan, Visakh
AU - Murray, Lynnette
AU - Mühlan, Holger
AU - Nair, Nandesh
AU - Negru, Ancuta
AU - Nelson, David
AU - Newcombe, Virginia
AU - Nieboer, Daan
AU - Noirhomme, Quentin
AU - Nyirádi, József
AU - Oddo, Mauro
AU - Oldenbeuving, Annemarie
AU - Oresic, Matej
AU - Ortolano, Fabrizio
AU - Palotie, Aarno
AU - Parizel, Paul M.
AU - Patruno, Adriana
AU - Payen, Jean François
AU - Perera, Natascha
AU - Perlbarg, Vincent
AU - Persona, Paolo
AU - Peul, Wilco
AU - Piippo-Karjalainen, Anna
AU - Floury, Sébastien Pili
AU - Pirinen, Matti
AU - Ples, Horia
AU - Poca, Maria Antonia
AU - Polinder, Suzanne
AU - Pomposo, Inigo
AU - Posti, Jussi
AU - Puybasset, Louis
AU - Radoi, Andreea
AU - Ragauskas, Arminas
AU - Raj, Rahul
AU - Rambadagalla, Malinka
AU - Real, Ruben
AU - Rehorčíková, Veronika
AU - Rhodes, Jonathan
AU - Ripatti, Samuli
AU - Rocka, Saulius
AU - Roe, Cecilie
AU - Roise, Olav
AU - Roks, Gerwin
AU - Rosand, Jonathan
AU - Rosenfeld, Jeffrey
AU - Rosenlund, Christina
AU - Rosenthal, Guy
AU - Rossaint, Rolf
AU - Rossi, Sandra
AU - Rueckert, Daniel
AU - Rusnák, Martin
AU - Sacchi, Marco
AU - Sahakian, Barbara
AU - Sahuquillo, Juan
AU - Sakowitz, Oliver
AU - Sala, Francesca
AU - Sanchez-Porras, Renan
AU - Sandor, Janos
AU - Santos, Edgar
AU - Sasu, Luminita
AU - Savo, Davide
AU - Schäffer, Nadine
AU - Schipper, Inger
AU - Schlößer, Barbara
AU - Schmidt, Silke
AU - Schoechl, Herbert
AU - Schoonman, Guus
AU - Schou, Rico Frederik
AU - Schwendenwein, Elisabeth
AU - Schöll, Michael
AU - Sir, Özcan
AU - Skandsen, Toril
AU - Smakman, Lidwien
AU - Smeets, Dirk
AU - Smielewski, Peter
AU - Sorinola, Abayomi
AU - Stamatakis, Emmanuel
AU - Stanworth, Simon
AU - Steinbüchel, Nicole
AU - Stevanovic, Ana
AU - Stevens, Robert
AU - Stewart, William
AU - Steyerberg, Ewout W.
AU - Sundström, Nina
AU - Synnot, Anneliese
AU - Taccone, Fabio Silvio
AU - Takala, Riikka
AU - Tamás, Viktória
AU - Tanskanen, Päivi
AU - Taylor, Mark Steven
AU - Te Ao, Braden
AU - Tenovuo, Olli
AU - Telgmann, Ralph
AU - Teodorani, Guido
AU - Theadom, Alice
AU - Thomas, Matt
AU - Tibboel, Dick
AU - Tolias, Christos
AU - Tshibanda, Jean Flory Luaba
AU - Trapani, Tony
AU - Tudora, Cristina Maria
AU - Vajkoczy, Peter
AU - Vallance, Shirley
AU - Valeinis, Egils
AU - Van Der Steen, Gregory
AU - Van Der Naalt, Joukje
AU - Van Essen, Thomas A.
AU - Van Hecke, Wim
AU - Van Heugten, Caroline
AU - Van Praag, Dominique
AU - Vyvere, Thijs Vande
AU - Van Waesberghe, Julia
AU - Vanhaudenhuyse, Audrey
AU - Vargiolu, Alessia
AU - Vega, Emmanuel
AU - Velt, Kimberley
AU - Verheyden, Jan
AU - Vespa, Paul M.
AU - Vik, Anne
AU - Vilcinis, Rimantas
AU - Vizzino, Giacinta
AU - Vleggeert-Lankamp, Carmen
AU - Volovici, Victor
AU - Voormolen, Daphne
AU - Vulekovic, Peter
AU - Vámos, Zoltán
AU - Wade, Derick
AU - Wang, Kevin K.W.
AU - Wang, Lei
AU - Wessels, Lars
AU - Wildschut, Eno
AU - Williams, Guy
AU - Wilson, Lindsay
AU - Winkler, Maren K.L.
AU - Wolf, Stefan
AU - Ylén, Peter
AU - Younsi, Alexander
AU - Zaaroor, Menashe
AU - Zhihui, Yang
AU - Ziverte, Agate
AU - Zumbo, Fabrizio
N1 - Funding Information: Data used in preparation of this manuscript were obtained in the context of the CENTER-TBI study, a large collaborative project, supported by the Framework 7 program of the European Union (602150). The funder had no role in the design of the study, the collection, analysis, and interpretation of data, or in writing the manuscript. DKM was supported by a Senior Investigator Award from the National Institute for Health Research (UK). The funder had no role in the design of the study, the collection, analysis, and interpretation of data, or in writing the manuscript. Funding Information: 24 Department of Neurosurgery & Anesthesia & Intensive Care Medicine, Karolinska University Hospital, Stockholm, Sweden. 25 NIHR Surgical Reconstruction and Microbiology Research Centre, Birmingham, UK. 26 Intensive Care Unit, CHU Poitiers, Poitiers, France. 27 Anesthesie-Réanimation, Assistance Publique—Hopitaux de Paris, Paris, France. 28 Department of Anesthesia & ICU, AOU Città della Salute e della Scienza di Torino—Orthopedic and Trauma Center, Torino, Italy. 29 Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany. 30 Department of Neurology, Odense University Hospital, Odense, Denmark. 31 Department of Anesthesiology & Intensive Care, University Hospital of Grenoble, Grenoble, France. 32 BehaviourWorks Australia, Monash Sustainability Institute, Monash University, VIC, Australia. 33 Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia. 34 Quesgen Systems Inc., Burlingame, CA, USA. 35 Australian & New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. 36 Department of Neurosurgery, Umea University Hospital, Umea, Sweden. 37 Department of Neurosurgery, University of Pecs and MTA-PTE Clinical Neuroscience MR Research Group and Janos Szentagothai Research Centre, University of Pecs, Hungarian Brain Research Program, Pecs, Hungary. 38 Department of Medical Psychology, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany. 39 Neuro ICU, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy. 40 ANZIC Research Centre, Monash University, Department of Epidemiology and Preventive Medicine, Melbourne, Vitoria, Australia. 41 Department of Neurosurgery, Hospital of Cruces, Bilbao, Spain. 42 Intensive Care and Department of Pediatric Surgery, Erasmus University Medical Center, Sophia Children’s Hospital, Rotterdam, the Netherlands. 43 Department of Neurosurgery, Hospital Universitario 12 de Octubre, Madrid, Spain. 44 Department of Neuroscience, Azienda Ospedaliera Università di Padova, Padova, Italy. 45 NeuroIntensive Care, ASST di Monza, Monza, Italy. 46 School of Medicine and Surgery, Università Milano Bicocca, Milan, Italy. 47 Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands. 48 Department of Anaesthesiology, University Hospital of Aachen, Aachen, Germany. 49 Department of Anesthesia & Neurointensive Care, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK. 50 Movement Science Group, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK. 51 School of Public Health & PM, Monash University and The Alfred Hospital, Melbourne, VIC, Australia. 52 Radiology/MRI Department, MRC Cognition and Brain Sciences Unit, Cambridge, UK. 53 Institute of Medical Psychology and Medical Sociology, Universitätsmedizin Göttingen, Göttingen, Germany. 54 Oxford University Hospitals NHS Trust, Oxford, UK. 55 Department of Neurosurgery, University of Pecs and MTA-PTE Clinical Neuroscience MR Research Group and Janos Szentagothai Research Centre, University of Pecs, Hungarian Brain Research Program (Grant No. KTIA 13 NAP-A-II/8), Pecs, Hungary. 56 Brain Physics Lab, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK. 57 Intensive Care Unit, CHR Citadelle, Liège, Belgium. 58 Intensive Care Unit, CHU, Liège, Belgium. 59 Movement Science Group, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK. 60 Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, Edegem, Belgium. 61 Department of Anesthesia & Intensive Care, Maggiore Della Carità Hospital, Novara, Italy. 62 Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium. Publisher Copyright: © 2018 The Author(s).
PY - 2018/11/16
Y1 - 2018/11/16
N2 - 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.
AB - 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.
KW - Brain death
KW - Ethics
KW - Postmortem organ donation
KW - Traumatic brain injury
KW - Ventricular drainage
KW - Withdrawing life-sustaining measures
UR - http://www.scopus.com/inward/record.url?scp=85056714365&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85056714365&partnerID=8YFLogxK
U2 - 10.1186/s13054-018-2241-4
DO - 10.1186/s13054-018-2241-4
M3 - Article
C2 - 30446017
AN - SCOPUS:85056714365
VL - 22
JO - Critical Care
JF - Critical Care
SN - 1364-8535
IS - 1
M1 - 306
ER -