Current Considerations in the Issue of Brain Death

Current Considerations in the Issue of Brain Death AbstractBRAIN DEATH IS an anatomically and physiologically complex process. The societal and psychological implications of brain death and organ donation are equally complex, and they have profound ramifications. Because the vast majority of organ donors die as a consequence of catastrophic intracranial processes, neurosurgeons are in a unique position to positively influence the supply of transplantable organs. Enhanced knowledge of the physiology of evolving brain death will improve the care of potential organ donors and increase the probability of successful transplantation. Likewise, better information about patient and family directives, beliefs, grieving, concurrent exposure to other health care workers, and experiences in the hospital environment will assist the neurosurgeon in providing the family with the opportunity for donation. Neurosurgeons can also play a leading role in the multidisciplinary approach required to support the families of potential organ donors during the transition from neurointerventional therapy to somatic support. New federal regulations on organ donation and a review of the literature about the “art of asking” are presented. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Current Considerations in the Issue of Brain Death

Current Considerations in the Issue of Brain Death

David J. Powner, M.D., Joseph M. Darby, M .D. Departments of Anesthesiology/Critical Care M edicine and Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania B R A IN D EATH IS an anatom ically and physiologically complex process. The societal and psychological implications of brain death and organ donation are equally complex, and they have profound ram ifications. Because the vast m ajority of organ donors die as a consequence of catastrophic intracranial processes, neurosurgeons are in a unique position to positively influence the supply of transplantable organs. Enhanced knowledge of the physiology of evolving brain death w ill im prove the care of potential organ donors and increase the probability of successful transplantation. Likewise, better inform ation about patient and fam ily directives, beliefs, grieving, concurrent exposure to other health care workers, and experiences in the hospital environm ent w ill assist the neurosurgeon in providing the fam ily w ith the opportunity for donation. Neurosurgeons can also play a leading role in the m ultidisciplinary approach required to support the fam ilies of potential organ donors during the transition from neurointerventional therapy to som atic support. N ew federal regulations on organ donation and a review of the literature about the "a rt of asking" are presented. (Neurosurgery 45:1222-1227, 1999) Key words: Brain death, Organ procurement, Organ transplantation, Transplantation hen optimal neurosurgical care cannot reverse the The early h em o d y n am ic changes show n in Table 1 maybe prim ary or secondary processes of brain injury and m ediated by high circulating levels of catecholamines (5) re­ brain death seems imminent, the neurosurgeon leased from the brain or from local "end-organ" cat­ must be prepared to address different priorities in the con­ echolamines discharged from sym pathetic nervous system tinuing care of the patient and his or her family....
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199911000-00042
Publisher site
See Article on Publisher Site

Abstract

AbstractBRAIN DEATH IS an anatomically and physiologically complex process. The societal and psychological implications of brain death and organ donation are equally complex, and they have profound ramifications. Because the vast majority of organ donors die as a consequence of catastrophic intracranial processes, neurosurgeons are in a unique position to positively influence the supply of transplantable organs. Enhanced knowledge of the physiology of evolving brain death will improve the care of potential organ donors and increase the probability of successful transplantation. Likewise, better information about patient and family directives, beliefs, grieving, concurrent exposure to other health care workers, and experiences in the hospital environment will assist the neurosurgeon in providing the family with the opportunity for donation. Neurosurgeons can also play a leading role in the multidisciplinary approach required to support the families of potential organ donors during the transition from neurointerventional therapy to somatic support. New federal regulations on organ donation and a review of the literature about the “art of asking” are presented.

Journal

NeurosurgeryOxford University Press

Published: Nov 1, 1999

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