Early detection of brain damage in emergency department and the organ donation process: a case series

Abstract

Brain death is defined as the irreversible loss of brain function following various pathophysiological changes. In many countries, the brain death diagnosis is carried out in conjunction with organ transplant programs. In Turkey, at third level health institutions in particular, healthcare units established entities that follow similar procedures. The increased number of patients waiting for organs and donor discovery studies have enhanced the public’s interest in this topic. Since the emergency department is usually the first line in admitting patients, its staff must have the firsthand knowledge of managing brain death and organ donation process. In this article, we present three clinical cases that we followed and diagnosed with brain death in our emergency department. Due to the lack of studies addressing brain death procedures in the emergency service, we believe that this report will greatly contribute to our awareness and handling of brain death treatment. 

Keywords

• Brain death,emergency medicine,organ donation

References

1. [1] Arsava EM, Demirkaya Ş, Dora B, Giray S, Gökçe M, Güler A, et al. [Turkish Neurological Society - Diagnostic guidelines for brain death]. Turk J Neurol 2014;20:101-4. [Article in Turkish]
2. [2] Nathan S, Greer DM. Brain death. Semin Anesth Perioper Med Pain 2006;25:225-31.
3. [3] Organ ve Doku Alınması, Saklanması, Aşılanması ve Nakli Hakkında Kanun, Pub. L. No. 2238 Stat. 16655 (29/5/1979).
4. [4] Organ ve Doku Nakli Hizmetleri Yönetmeliği Stat. 28191 (01/02/2012).
5. [5] Souter MJ, Blissitt PA, Blosser S, Bonomo J, Greer D, Jichici D, et al. Recommendations for the critical care management of devastating brain injury: prognostication, psychosocial, and ethical management: A Position Statement for Healthcare Professionals from the Neurocritical Care Society. Neurocrit Care 2015;23:4-13.
6. [6] Organ, Doku Nakli ve Diyaliz Hizmetleri Daire Başkanlığı Resmi Sayfası [cited 2017 01/12/2017]. Available from: https://organkds.saglik.gov.tr/KamuyaAcikRapor.aspx?q=YOBIS.
7. [7] Witjes M, Kotsopoulos A, Herold IHF, Otterspoor L, Simons KS, van Vliet J, et al. The influence of end-of-life care on organ donor potential. Am J Transplant 2017;17:1922-7.
8. [8] Sever M. [Problems and solution suggestions in renal transplantation in Turkey]. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi 2008;17(Suppl 1):3-8. [Article in Turkish]

9. [9] Kahveci E, Topçuoğlu BCV. Beyin ölümünden organ nakline - temel ilkeler ve pratik uygulamalar. Özyurt Matbaacılık: Ankara., 2015.
10. [10] Le Conte P, Riochet D, Labastire L, Auneau JC, Legeard E, Van Tricht M, et al. Identification of potential organ donors of advanced age in EDs. Am Emerg Med 2012;30:170-3.
11. [11] Riker RR, White BW. Organ and tissue donation from the emergency department. J Emerg Med 1991;9:405-10.