Evaluation of Non-donor Brain-Dead Patients

Abstract

Patients with chronic organ failure receive organs from living donors or brain-dead donors. In our country, brain death and organ transplantation procedures are carried out with Turkish Laws #2238 on the Harvesting, Storage, Grafting, and Transplantation of Organs and Tissues (June 3, 1979). Improvements in legislation have been made on the criteria of diagnosis of brain death and how diagnosis will be made. The recommendation for termination of life support of non-donor brain-dead patients was removed. Due to this uncertainty, hesitancy arises in terms of the discontinuation of life support among healthcare workers. In our study, we aimed to draw attention to the issue about the fate of non-donor brain-dead patients. Methods: In our study, we retrospectively evaluated data of brain-dead patients between January 1, 2011 and June 1, 2017 in our hospital. Results: Of the 122 patients with brain death, 102 were not donors. The mean lifetime of non-donor patients was 29±56 hours. It was observed that cardiac death occurred in the longest surviving patient after 116 hours following declaration. Thirty-five patients were given new vasopressor or inotropic drugs after brain death. Conclusion: The brain-dead person is considered medically and legally dead despite heartbeats. It is not reasonable to maintain the life support of the individual who is considered dead. Considering the insufficient number of intensive care units and the high cost of medical support, it is of great importance to establish legal arrangements that will allow the discontinuation of medical support that is useless in non-donor brain-dead patients and enable the use of life-supporting devices for the patients in the waiting list.

Beyi̇n Ölümü Tanisi Sonrasi Hasta Yakinlarinin Davranişlarinin İncelenmesi̇: Bi̇r Tip Fakültesi̇ Hastanesi̇ Uygulamasi

“…Bizim çalışmamızda ise en uzunu 216 saat, en kısası 1 saat olmak üzere, kalbin kendiliğinden durana kadar geçen süre ortalaması 42 saat bulunmuştur. Bu konuda farklı çalışmalarda farklı veriler elde edilmiştir: Karasu ve ark'nın yaptığı çalışmada 18 yaş altı 11 olguda ortalama 6,8 gün (1-28) ve 18 yaş ve üstü 43 olguda 2,5 gün (1-13) (11); Akbaş ve ark'nın yaptığı çalışmada 2 (1-10.6) saat (11); Al-Shammri ve ark'nın çalışmasında 1 ila 30 gün arasında (ortalama 8.20 gün, ortanca 6 gün) (13); Ceylan ve ark'nın çalışmasında ise beyin ölümü ve kalp ölümü arasındaki en uzun süre 116 saat olarak belirtilmiştir (14).…”