Brain death and organ donation in Argentine pediatric intensive care units. A multicenter study

Abstract

Brain death (BD) is a condition determined by the complete and irreversible absence of brain functions. Maintenance of vital functions creates an opportunity for organ donation. A retrospective study was carried out in 7 pediatric intensive care units of Argentina (from 1/1/2013 to 9/30/2016) to determine the incidence of clinical and certified BD, and the proportion of effective transplantations. Among deceased patients, 19.14% (147/768) met the clinical requirements for BD, and the main cause of BD was multiple trauma. BD was certified in 13.4% of deceased patients (103); an electroencephalogram and an apnea test were the most commonly used ancillary methods. Organ maintenance time was 24 hours. A total of 87 families were approached for donation; 59 were rejected (they were not suitable or refused). Effective donors accounted for 25% (26/103) of patients with certified BD and 72 patients received solid organs.

Evaluation of Pediatric Brain Death and Organ Donation: 10-Year Experience in a Pediatric Intensive Care Unit in Turkey

“…The recipient-to-donor ratio (solid organs) in their study was close to 4. 14 This ratio was 2 : 5 in Brierly’s study. 28 In our study, the recipient-to-donor ratio was found to be 2 : 6 (13 solid organs per 5 donors), which is comparable to the existing literature.…”

“…They also revealed that the combination of EEG and AT was the most used ancillary method, in about 65% of their study cohort, like the observation in our study. 14 Aslan et al 18 from Turkey reported similarly high rates of ancillary tests in their study group, including 20 pediatric BD cases. In their report, they showed that they routinely use EEG and AT in 19 out of 20 patients, whereas CTA/MRA was applied to 8 patients (40%).…”

“…EEG was performed in 16 patients (67%), whereas MRA/CTA was performed in 13 patients (54%). Bonetto et al 14 reported that EEG was the most commonly performed ancillary test (93.2%) to diagnose BD, and AT was performed in 69% of the whole cohort. CTA or MRA was much lower, at 10%, in comparison with our study.…”

“… 13 Morris et al, 27 from the UK, reported that nearly 50% of children with BD resulting from severe TBI, go on to OD, and this is one of the highest percentages in pediatric BD studies. 27 Bonetto et al 14 reported that 25% of their BD patients became donors, and 72 solid organs were transplanted into suitable patients. The recipient-to-donor ratio (solid organs) in their study was close to 4.…”

Lung donation and donor lung management: a survey among health care professionals in Argentina

“…Organ procurement is the process of collecting organs and tissues for transplantation to meet the needs of patients on transplant waiting lists. ( 1 ) A great number of health care professionals (HCPs) take part in this process, both at the in-hospital and out-of-hospital levels. The high demand for transplant organs does not match the number of actual organ donors, and this shortage of organs is the leading cause of death among patients on transplant waiting lists.…”