Variability in the Determination of Death After Cardiac Arrest

Dhanani, Sonny; Hornby, Laura; Ward, Roxanne; Shemie, Sam D.

doi:10.1177/0885066610396993

Cited by 74 publications

(69 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Determination of death varies in the different protocols, but also between ICUs. There is a lack of uniformity [19-21]. This includes the definition of death, the tests used to determine death and the period of time between death and the moment organs can be procured.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Variability in protocols on donation after circulatory death in Europe

et al. 2013

View full text Add to dashboard Cite

IntroductionOrgan donation after circulatory death (DCD) has become an accepted strategy to reduce the shortage of organs for transplantation in many European countries. The use and number of DCD donors varies between countries. The purpose of this study was to evaluate the available protocols for DCD in Europe.MethodsWe contacted national transplant societies and responsible transplant co-ordinators in the countries that perform DCD to obtain DCD protocols. We compared information on the protocols and additional data including: inclusion and exclusion criteria for donation, legislation, determination of death and preservation methods.ResultsIn ten European countries DCD is performed, eight of which describe the methods in protocols. There are large differences in used DCD categories, legislation and the way death is determined. Protocols differ in the detail in which DCD procedures are described and the way methods are supported by additional consensus statements and ethical frameworks.ConclusionsAlthough DCD is an established strategy to enlarge the donor pool and to contribute to the reduction of the waiting list for transplantation, its potential has not been fully utilized yet. To further promote DCD transplantation, it is important to share expertise and obtain consensus, so that this can be translated into more uniform and solid protocols supported by the competent authorities, transplant and intensive care professionals, which may eventually result in a further promotion of DCD transplantation in Europe.

show abstract

Section: Discussionmentioning

confidence: 99%

“…With the expansion of DCD programs, the lack of consensus about determination of death is a point of discussion and concern [22-24]. It is important to have clear, uniform and consistent evidence-based guidelines to determine death, in order to fulfill medical, ethical and legal obligations and to ensure public trust [19]. …”

Section: Discussionmentioning

confidence: 99%

Variability in protocols on donation after circulatory death in Europe

et al. 2013

View full text Add to dashboard Cite

show abstract

“…International practice varies with regard to this time interval between C-1 and C-2. The most common waiting period is 5 min with a range from 2 to 10 min [18]. The participants came to consensus on the ‘minimum acceptable clinical standards’ to test for the cessation of circulatory function (Table 3).…”

Section: Resultsmentioning

confidence: 99%

International guideline development for the determination of death

et al. 2014

Self Cite

View full text Add to dashboard Cite

Introduction and MethodsThis report summarizes the results of the first phase in the development of international guidelines for death determination, focusing on the biology of death and the dying process, developed by an invitational forum of international content experts and representatives of a number of professional societies.Results and ConclusionsPrecise terminology was developed in order to improve clarity in death discussion and debate. Critical events in the physiological sequences leading to cessation of neurological and/or circulatory function were constructed. It was agreed that death determination is primarily clinical and recommendations for preconditions, confounding factors, minimum clinical standards and additional testing were made. A single operational definition of human death was developed: ‘the permanent loss of capacity for consciousness and all brainstem functions, as a consequence of permanent cessation of circulation or catastrophic brain injury’. In order to complete the project, in the next phase, a broader group of international stakeholders will develop clinical practice guidelines, based on comprehensive reviews and grading of the existing evidence.

show abstract

“…In a majority of DCDD protocols, a stand-off period of 5 min is used, but the stand-off period varies between 2 and 20 min depending on the DCDD protocol 12. Because the heart is sensitive to WIT, a reduced stand-off period was used in the heart DCDD protocols of Denver (75 s and 3 min)2 and Sydney (2 min for two donors) 3…”

Section: Medical Considerations—description Of Heart Dcdd Protocolsmentioning

confidence: 99%

“…Typically in the intensive care unit (ICU) setting, ICU physicians declare death after 2–10 min of cessation of cardiocirculatory functions,12 and thus long before the point at which the function of all bodily cells has ceased. This criterion of death is unnecessarily conservative, is incompatible with usual medical practice and eliminates all organ transplantation 13…”

Section: Analysis Of the Dead Donor Rule In Heart Dcddmentioning

confidence: 99%

An analysis of heart donation after circulatory determination of death

Ave¹,

Shaw

Bernat

2016

J Med Ethics

View full text Add to dashboard Cite

Only death criteria based on permanency are compatible with the DDR under two conditions: (1) a minimum stand-off period of 5 min to ensure that autoresuscitation is impossible and that all brain functions have been lost and (2) no medical intervention is undertaken that might resume bodily or brain circulation. By our analysis, only the Australia heart DCDD programme using a stand-off period of 5 min respects the DDR when the criteria of death are based on permanency.

show abstract

Variability in the Determination of Death After Cardiac Arrest

Cited by 74 publications

References 64 publications

Variability in protocols on donation after circulatory death in Europe

Variability in protocols on donation after circulatory death in Europe

International guideline development for the determination of death

An analysis of heart donation after circulatory determination of death

Contact Info

Product

Resources

About