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Review Article
Ethics
Medical Management of Brain-Dead Organ Donors
A.S.M. Tanim Anwar, Jae-myeong Lee
Acute Crit Care. 2019;34(1):14-29.   Published online February 28, 2019
DOI: https://doi.org/10.4266/acc.2019.00430
  • 23,735 View
  • 1,440 Download
  • 29 Web of Science
  • 36 Crossref
AbstractAbstract PDF
With improving healthcare services, the demand for organ transplants has been increasing daily worldwide. Deceased organ donors serve as a good alternative option to meet this demand. The first step in this process is identifying potential organ donors. Specifically, braindead patients require aggressive and intensive care from the declaration of brain death until organ retrieval. Currently, there are no specific protocols in place for this, and there are notable variations in the management strategies implemented across different transplant centers. Some transplant centers follow their own treatment protocols, whereas other countries, such as Bangladesh, do not have any protocols for potential organ donor care. In this review, we discuss how to identify brain-dead donors and describe the physiological changes that occur following brain death. We then summarize the management of brain-dead organ donors and, on the basis of a review of the literature, we propose recommendations for a treatment protocol to be developed in the future.

Citations

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  • Donor Pericardial Interleukin and Apolipoprotein Levels May Predict the Outcome after Human Orthotopic Heart Transplantation
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  • A Conceptual Framework for Evaluating National Organ Donation and Transplantation Programs
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Case Report
Neurology/Cardiology
Extracorporeal Membrane Oxygenation for the Support of a Potential Organ Donor with a Fatal Brain Injury before Brain Death Determination
Sung Wook Chang, Sun Han, Jung Ho Ko, Jae-Wook Ryu
Korean J Crit Care Med. 2016;31(2):169-172.   Published online May 31, 2016
DOI: https://doi.org/10.4266/kjccm.2016.31.2.169
  • 6,081 View
  • 109 Download
  • 1 Crossref
AbstractAbstract PDF
The shortage of available organ donors is a significant problem and various efforts have been made to avoid the loss of organ donors. Among these, extracorporeal membrane oxygenation (ECMO) has been introduced to help support and manage potential donors. Many traumatic brain injury patients have healthy organs that might be eligible for donation for transplantation. However, the condition of a donor with a fatal brain injury may rapidly deteriorate prior to brain death determination; this frequently results in the loss of eligible donors. Here, we report the use of venoarterial ECMO to support a potential donor with a fatal brain injury before brain death determination, and thereby preserve donor organs. The patient successfully donated his liver and kidneys after brain death determination.

Citations

Citations to this article as recorded by  
  • Outcomes of Extracorporeal Membrane Oxygenation in Children: An 11-Year Single-Center Experience in Korea
    Hongsun Kim, Ji-Hyuk Yang, Yang Hyun Cho, Tae-Gook Jun, Kiick Sung, Woosik Han
    The Korean Journal of Thoracic and Cardiovascular Surgery.2017; 50(5): 317.     CrossRef
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