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Assessment, Monitoring, and Management of Brain-Dead Potential Organ Donors in Europe

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The Brain-Dead Organ Donor

Abstract

With 34 donors per million population, Spain has impressed the international transplant community with the world’s highest rate of organ donation (double the European average), short waiting lists, and reduced reliance on living donation. These data account for the World Health Organization’s strategy for extending the so-called Spanish Model across the globe, and for the European Parliament’s decision, on May 19, 2010, to incorporate some of the elements of the Spanish Model in its Action Plan on organ donation and transplantation. At present, there are a number of organ transplantation organizations in Europe, though no standardized protocol exists for all countries, and no standardized laws are in place. We describe the most successful model (the Spanish Model for organ donation) and describe in detail the most important recommendations of the 2009 Council of Europe’s “Guide to Safety and Quality Assurance for the Transplantation of Organs, Tissues and Cells.”

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References

  1. Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death. A definition of irreversible coma. JAMA. 1968;205:337–40.

    Google Scholar 

  2. Transplant Committee of the Council of Europe. International data on organ donation and transplantation 2008, 2009, 2010. Newsl Transplant. http://www.ont.es/publicaciones/Documents/Newsletter2010.pdf. Accessed May 2011.

  3. European parliament on organ donation and transplantation. http://www.europarl.europa.eu/sides/getDoc.do?type=TA&reference=P7-TA-2010–0181&format=XML&language=EN. Accessed 19 July 2010.

  4. Matesanz R, Domínguez-Gil B. Pros and cons of a regulated market in organs. Lancet. 2009; 374(9707):2049.

    Article  PubMed  Google Scholar 

  5. World health organization statements on organ transplantation. http://www.who.int/transplantation/en. Accessed 20 Nov 2010.

  6. Rodríguez-Arias D, Wright L, Paredes D. Success factors and ethical challenges of the Spanish Model of organ donation. Lancet. 2010;376(9746):1109–12.

    Article  PubMed  Google Scholar 

  7. Council of Europe, Guide to safety and quality assurance for the transplantation of organs, tissues and cells. Strasbourg, France: Council of Europe Publishing; 2009.

    Google Scholar 

  8. Global education initiatives; Matesanz R, Coll E, Dominguez- Gil B, Et al. http://www.ont.es/publicaciones/Documents/Articulos/Trasplantation_Global_Education_Initiatives.pdf. Accessed 18 Aug, 2012.

  9. Mollaret P, Goulon M. Coma de´passe´ (preliminary memoir). Rev Neurol (Paris). 1959;101:3–15.

    CAS  Google Scholar 

  10. Rampino T, Abelli M, Ticozzelli E, et al. Non-heart-beating-donor transplant: the first experience in Italy. G Ital Nefrol. 2010;27:56–68.

    PubMed  Google Scholar 

  11. Koffman G, Gambaro G. Renal transplantation from non-heart-beating donors: a review of the European experience. J Nephrol. 2003;16:334–41.

    PubMed  Google Scholar 

  12. Mateos-Rodríguez A, Pardillos-Ferrer L, Navalpotro-Pascual JM, et al. Kidney transplant function using organs from non-heart-beating donors maintained by mechanical chest compressions. Resuscitation. 2010; 81:904–7.

    Article  PubMed  Google Scholar 

  13. García-Valdecasas JC, Fondevila C. In-vivo normothermic recirculation: an update. Curr Opin Organ Transplant. 2010;15:173–6.

    Article  PubMed  Google Scholar 

  14. Gozzini S, Perera MT, Mayer DA, et al. Liver transplantation in children using non-heart-beating donors (NHBD). Pediatr Transplant. 2010;14:554–7.

    Article  PubMed  CAS  Google Scholar 

  15. Van Raemdonck DE, Rega FR, Neyrinck AP, et al. Non-heart-beating donors. Semin Thorac Cardiovasc Surg. 2004;16:309–21.

    Article  PubMed  Google Scholar 

  16. Cobianchi L, Zonta S, Vigano J, et al. Experimental small bowel transplantation from non-heart-beating donors: a large-animal study. Transplant Proc. 2009;41:55–6.

    Article  PubMed  CAS  Google Scholar 

  17. Kootstra G, Daemen JH, Oomen AP. Categories of non-heart-beating donors. Transplant Proc. 1995;27:2893–4.

    PubMed  CAS  Google Scholar 

  18. Kootstra G, van Heurn E. Non-heartbeating donation of kidneys for transplantation. Nat Clin Pract Nephrol. 2007;3:154–63.

    Article  PubMed  Google Scholar 

  19. Nickkholgh A, Weitz J, Encke J, Sauer P, et al. Utilization of extended donor criteria in liver transplantation: a comprehensive review of the literature. Nephrol Dial Transplant. 2007;22 Suppl 8:viii29–36.

    Google Scholar 

  20. Durand F, Renz JF, Alkofer B, et al. Report of the Paris consensus meeting on expanded criteria donors in liver transplantation. Liver Transpl. 2008;14: 1694–707.

    Article  PubMed  Google Scholar 

  21. Rao PS. The alphabet soup of kidney transplantation: SCD, DCD, ECD—fundamentals for the practicing nephrologist. Clin J Am Soc Nephrol. 2009;4: 1827–31.

    Article  PubMed  Google Scholar 

  22. Miles CD, Schaubel DE, Jia X, et al. Mortality experience in recipients undergoing repeat transplantation with expanded criteria donor and non-ECD deceased-donor kidneys. Am J Transplant. 2007;7:1140–7.

    Article  PubMed  CAS  Google Scholar 

  23. Remuzzi G, Grinyò J, Ruggenenti P, et al. Early experience with dual kidney transplantation in adults using expanded donor criteria. Double Kidney Transplant Group (DKG). J Am Soc Nephrol. 1999;10:2591–8.

    PubMed  CAS  Google Scholar 

  24. Koopman-van Gemert AW. Hemodilution, what is right? Transplant Proc. 1996;28:2934–6.

    Google Scholar 

  25. Goldberg RJ, Smits G, Wiseman AC. Long-term impact of donor-recipient size mismatching in deceased donor kidney transplantation and in expanded criteria donor recipients. Transplantation. 2010;90:867–774.

    Article  PubMed  Google Scholar 

  26. Mazariegos GV, Steffick DE, Horslen S, et al. Intestine transplantation in the United States, 1999–2008. Am J Transplant. 2010;10:1020–34.

    Article  PubMed  CAS  Google Scholar 

  27. Wood KE, Becker BN, McCartney JG, et al. Care of the potential organ donor. N Engl J Med. 2004;351: 2730–9.

    Article  PubMed  CAS  Google Scholar 

  28. Cooper DKC, Novitzky D, Wicomb WN. The pathophysiological effects of brain death on potential donor organs, with particular reference to the heart. Ann R Coll Surg Engl. 1989;71:261–6.

    PubMed  CAS  Google Scholar 

  29. Novitzky D. Heart transplantation, euthyroid sick syndrome, and triiodothyronine replacement. J Heart Lung Transplant. 1992;11:196–8.

    Google Scholar 

  30. D’Amico TA, Schwinn DA, Meyers CH, et al. Desensitization of myocardial β-adrenergic receptors after brain death. Surg Forum. 1992;43:249–51.

    Google Scholar 

  31. Bittner HB, Kendall SW, Chen EP, et al. Endocrine changes and metabolic responses in a validated canine brain death model. J Crit Care. 1995;10:56–63.

    Article  PubMed  CAS  Google Scholar 

  32. Chen EP, Bittner HB, Kendall SW, et al. Hormonal and hemodynamic changes in a validated animal model of brain death. Crit Care Med. 1996;24: 1352–9.

    Article  PubMed  CAS  Google Scholar 

  33. Totsuka E, Dodson F, Urakami A, et al. Influence of high donor serum sodium levels on early postoperative graft function in human liver transplantation: effect of correction of donor hypernatremia. Liver Transpl Surg. 1999;5:421–8.

    Article  PubMed  CAS  Google Scholar 

  34. Mangus RS, Fridell JA, Vianna RM, et al. Severe hypernatremia in deceased liver donors does not impact early transplant outcome. Transplantation. 2010;90:438–43.

    Article  PubMed  Google Scholar 

  35. Dictus C, Vienenkoetter B, Esmaeilzadeh M, et al. Critical care management of potential organ donors: our current standard. Clin Transplant. 2009;23 Suppl 21:2–219.

    Article  PubMed  Google Scholar 

  36. Novitzky D, Cooper DKC, Rosendale JD, et al. Hormonal therapy of the brain-dead organ donor: experimental and clinical studies. Transplantation. 2006;82:1396–401.

    Article  PubMed  CAS  Google Scholar 

  37. Ekser B, Ezzelarab M, Hara H, et al. Clinical xeno- transplantation—the next great medical revolution? Lancet. 2012;379(9816):672–83.

    Google Scholar 

  38. Triolo F, Gridelli B. End-stage organ failure: will regenerative medicine keep its promise? Cell Transplant. 2006;15 Suppl 1:S3–10.

    Article  PubMed  Google Scholar 

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Correspondence to Bruno G. Gridelli M.D. .

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Echeverri, G.J., Gridelli, B.G. (2013). Assessment, Monitoring, and Management of Brain-Dead Potential Organ Donors in Europe. In: Novitzky, D., Cooper, D. (eds) The Brain-Dead Organ Donor. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4304-9_18

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  • DOI: https://doi.org/10.1007/978-1-4614-4304-9_18

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