The Diagnosis of Brain Death

  • S. M. Gritsenko Zaporizhia Medical Academy of Post-Graduate Education Ministry of Health of Ukraine, Zaporizhzhia, Ukraine
Keywords: organ transplantation, brain death, diagnostic

Abstract

Organ transplantation is impossible without donation which is performed both intra vitam and posthumously. Each case of multi-organ collection provides help to 4 to 6 patients. We believe that presentation of modern algorithms for diagnosing brain death is quite feasible, and such information can be useful not only for anesthesiologists, but also for doctors of other specialties. This paper presents materials related to organ donation. Diagnostic criteria for human brain death, as well as the procedure for ascertaining human brain death and the actions of doctors of healthcare institutions in relation to persons who are in these institutions and who have clinical indications for the diagnosis of brain death, are determined by "The procedure for cancellation of active measures to maintain the patient's life…". Active measures (ventilation, infusion therapy and vasopressor support, etc.) to support the patient's life are cancelled after the patient's brain death is ascertained, except for cases where the deceased person is considered a potential donor. Verification of the human brain death is carried out by the case management team of the healthcare institution involving, if necessary, members of consultative and diagnostic mobile team, specialists of other healthcare institutions. The head of the healthcare institution is responsible for timely and proper engagement and work of the case management team. The responsible person determines the membership of the case management team by making an appropriate entry in the case record and is responsible for its work.

An anesthesiologist and a neurologist (neurosurgeon) who have at least 5 years of practical experience in the specialty are engaged in the case management team to ascertain brain death in persons over 18 years of age.

Physicians involved in the removal of human anatomical materials and transplantation thereof, as well as transplant coordinator, may not be included in the case management team.

References

  1. Medychna biolohiia. Transplantatsiia orhaniv i tkanyn, vydy transplantatsii [Medical biology. Organ and tissue transplantation, types of transplantation] [Internet]. Subject.com [cited 2020 Sept 10]. Available from: https://subject.com.ua/biology/medical/163.html
  2. World Health Organization. Guiding Principles on human cell, tissue and organ transplantation. Sixtythird World Health Assembly, in Resolution WHA63.22; 2010 May 17-21; Geneva, Switzerland. Available from: who.int/transplantation/Guiding_PrinciplesTransplantation_WHA63.22en.pdf
  3. Pro zastosuvannia transplantatsii anatomichnykh materialiv liudyni. Zakon Ukrainy 2018 No. 2427-VIII [On the application of transplantation of anatomical materials to a person Law of Ukraine of 2018, No. 2427-VIII]. Ukrainian. Available from: https://zakon.rada.gov.ua/laws/show/2427-19
  4. Pro vnesennia zmin do deiakykh zakonodavchykh aktiv Ukrainy, shcho rehuliuiut pytannia transplantatsii anatomichnykh materialiv liudyny. Zakon Ukrainy 20.12.2019 No. 418-IX [On Amendments to Some Legislative Acts of Ukraine Regulating the Issue of Transplantation of Human Anatomical Materials Law of Ukraine of 2019, No. 418-IX)]. Ukrainian. Available from: https://zakon.rada.gov.ua/laws/show/418-20
  5. Wijdicks EF, Varelas PN, Gronseth GS, Greer DM; American Academy of Neurology. Evidence-based guideline update: Determining brain death in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2010 Jun 8;74(23):1911-1918. https://doi.org/10.1212/WNL.0b013e3181e242a8
  6. Pro vstanovlennia diahnostychnykh kryteriiv smerti mozku ta protsedury konstatatsii momentu smerti liudyny. Nakaz Ministerstva okhorony zdorovia Ukrainy 23.09.2013 No. 821 [On the establishment of diagnostic criteria for brain death and the procedure for establishing the moment of death of a person Order of 2013, No. 821]. Ukrainian.
  7. Pro informatsiiu. Zakon Ukrainy 2020 No. 2657-XII [The Law of Ukraine on Information of 2020, No. 2657-XII]. Ukrainian. Available from: https://zakon.rada.gov.ua/laws/show/2657-12
  8. Pro deiaki pytannia udoskonalennia roboty viddilen anesteziolohii ta intensyvnoi terapii zakladiv okhorony zdorovia. Nakaz Ministerstva okhorony zdorovia Ukrainy 09.11.2020 No. 2559 [On Some Issues of Improving the Work of Departments of Anesthesiology and Intensive Care of Health Care Institutions Order of 2020, No. 2559]. Ukrainian.
Published
2021-10-27
How to Cite
Gritsenko, S. M. (2021). The Diagnosis of Brain Death. Transplantation and Artificial Organs, (2 (03), 84-101. https://doi.org/10.30702/transpaorg/10_21.2710/1384-101/88.07
Section
SCIENTIFIC PUBLICATIONS