Brain death and organ transplantation


Brain death is an irreversible extinction of all brain functions including brainstem functions despite of the working cardiovascular system or other organs. The organ donor can be living human or the organ can be taken from the body of dead one. The condition is free and voluntary donor decision. The dead donor is in most cases a person, whose brain damage leads to its death, which  has to be medicaly very precisely examinated and confirmed by objective screening procedure.

2018
brain death
transplantation
care of organ donor
contraindication
apnea test
verification
confirmation
Published at: 1.6.2018

Review

Peter Sklienka, MD
Senior Consultant, ICU, Department of Anesthesiology, Resuscitation and Intensive Care, University Hospital in Ostrava, Ostrava, Czech Republic

The algorithm shows the problems of the brain death diagnosis and the indication for the organ removal from the donor in a very clear and comprehensible form. The introductory part discusses in detail the crucial aspects of clinical diagnosis of brain death, as well as its subsequent verification by imaging or electrophysiological methods. This procedure clearly shows both the autonomy of competent doctors in the diagnosis of brain death, as well as the necessary early and a close co-operation with the transplant coordinators. There is also mentioned a need of the hightquality donor care from the diagnosis of brain death to the time of organ removal.
Throughout the algorithm, there is emphasis placed on the basic medical, legislative and ethical principles in a coherent chain of time. This is why can be the algorithm  used not only for teaching but also as a brief manual in common clinical practice. In conclusion, I would like to congratulate and thank the authors for their exact work on the issue of brain death.

Sources

KIESLICHOVÁ, Eva. Dárci orgánů. Praha: Maxdorf, 2015. Jessenius. ISBN 978-80-7345-451-7.

WELSCHEHOLD, BOOR, et. al.. Technical Aids in the Diagnosis of Brain Death. Deutsches Ärzteblatt International. [online]. 2012, 109(39): 624−30 [cit. 2017-12-10]. Avaible from: http://cmp-manual.wbs.cz/smrt_mozku/literatura/technical_aids_in_brain_death.pdf

Zákon č. 285/2002 Sb included novelization 2013.: Zákon o darování, odběrech a transplantacích tkání a orgánů a o změně některých zákonů (transplantační zákon). www.zakonyprolidi.cz [online]. [cit. 2017-12-10]. Avaible from: https://www.zakonyprolidi.cz/cs/2002-285

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