Retrospective Analysis of Brain Death Cases

Abstract

Objective: Organ transplantation is important for patients with end-stage organ failure to survive. For this reason, detection of brain death cases and adequate number of donations are necessary. Methods: 31 cases diagnosed with brain death between 01.01.2018-01.01.2020 were evaluated retrospectively. Demographic characteristics, diagnoses causing brain death, time to detect brain death, additional tests applied for the diagnosis of brain death, time to diagnosis of brain death and cardiopulmonary arrest or donation, the proportion of families accepting organ donation, the proportion of donors, organ removed from donors the number and blood types of the cases were recorded Results: The number of cases diagnosed with brain death was 31, and the mean age of the cases was 46,71 (1-89) years. 71% (n=22) of the patients were admitted to the intensive care unit from the emergency department. The most common reason for admission to the intensive care unit 67.7% (n=21) was intracranial bleeding. While the family donation rate was 19% (n=5), three cases who accepted the donation could be donors. The mean age of the patients for whom organ donation was accepted was 35.80±11 years, while the mean age of the patients for whom organ donation was not accepted was 57.43±21.30 years (p=0.04). Conclusion: Due to the increasing number of end-stage organ failure patients awaiting transplantation, it is necessary to increase the number of cadaveric donors. Timely and sufficient detection of brain death cases, increasing the family donation rate and increasing the number of cadaveric donors will be contributed.

Evaluation of patients diagnosed with brain death in the intensive care unit: 10 years of tertiary center experience in Istanbul

“…A study from Turkiye stated that the most common reason for the rejection of organ donation was religious reasons [ 10 ]. For organs to be harvested in cases of brain death in Turkiye, it is sufficient to state in an official or written will that they donated their organs for treatment, diagnosis, and scientific purposes while alive [ 2 ]. Even if there is an organ donation card, it is prioritized to obtain the families’ consent to avoid family disputes.…”

“…Studies from Turkiye have reported that the diagnosis of brain death is more common in males [ 2 – 4 , 10 – 13 ]. In a study from Iran [ 14 ], the rate of men was higher, while in a study from South Korea [ 15 ], more cases of brain death were reported in women.…”

“…Akbas et al [ 12 ] reported the mean age of brain death cases as 62±14. Ozkan Kuscu et al [ 2 ] said that the mean age of the patients whose families accepted organ donation was significantly lower than that of those who did not (35±11 vs. 57±21). Boran et al [ 10 ] also reported that the mean age of patients whose families accepted organ donation was lower than those who did not, although it was not significant.…”

“…The hospital units to which brain death cases first applied and the time spent there are essential for early diagnosis. Studies from Turkiye reported that 63–71% of brain death cases were admitted to ICUs from the emergency services most frequently [ 1 , 2 , 5 ]. In our study, following the literature, the highest rate of patients (55%) was hospitalized from the emergency department to the ICU.…”

“…The three main findings of the clinical diagnosis of brain death are irreversible coma, brainstem areflexia, and positive apnea test [ 1 ]. According to the latest regulation published in Turkiye, a diagnosis of brain death can be made with the unanimous consent of 2 specialists, one of whom is a Neurology or Neurosurgery specialist, and the other is an Intensive Care or Anesthesiology and Reanimation Specialist [ 2 ].…”