Anest. intenziv. Med. 2014;25(4):301-306

Organ retrieval from a donor after circulatory arrest - case report and reviewIntesive Care Medicine - Review Article

Rusinová Kateřina1,2,*, Pokorná Eva3, Vávra Václav1, Kusová Dagmar1, Janoušek Libor4, Froněk Jiří4, Stach Zdeněk1, Turčianský Martin1, Otáhal Michal1, Doležal Adam1, Černý David2, Balík Martin1, Černý Vladimír5,6
1 Klinika anesteziologie, resuscitace a intenzivní medicíny, 1. lékařská fakulta Univerzity Karlovy a Všeobecná fakultní nemocnice, Praha
2 Ústav pro humanitní studia v lékařství, 1. lékařská fakulta Univerzity Karlovy, Praha
3 Oddělení odběru orgánů a transplantačních databází, Transplantacentrum, Institut klinickéa experimentální medicíny, Praha
4 Klinika transplantační chirurgie, Institut klinické a experimentální medicíny, Praha
5 Fakultní nemocnice Hradec Králové, Klinika anesteziologie, resuscitace a intenzivní medicíny, Hradec Králové
6 Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada

This case study reports the initial management, prognosis assessment and withdrawal of life support followed by retrieval of vital organs for transplantation in a patient admitted after out-of-hospital cardiac arrest. This is the first description of a case of controlled donation after circulatory death in the Czech Republic. We discuss in detail the practical aspects of organ retrieval management, the role of echocardiography in circulatory arrest, indication of palliative treatment including terminal weaning and determining death due to circulatory arrest. We also emphasize communication with family members. The protocol used to determine death after circulatory arrest is presented along with the basic ethical and legal considerations in this sub-group of organ donors.

Keywords: irreversible circulatory arrest; death determinativ; transplant law; palliative care; echocardiography

Received: February 18, 2014; Accepted: April 2, 2014; Published: August 1, 2014  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Rusinová K, Pokorná E, Vávra V, Kusová D, Janoušek L, Froněk J, et al.. Organ retrieval from a donor after circulatory arrest - case report and review. Anest. intenziv. Med. 2014;25(4):301-306.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Manara, A. R., Murphy, P. G., O'Callaghan, G. Donation after circulatory death. Br. J. Anaesth., 2012, 108, p. 108-121. Go to original source... Go to PubMed...
    2. Ledinh, H., Bonvoisin, C., Weekers, L., de Roover, A., Hono-ré, P., Squifflet, J. P. et al. Results of kidney transplantation from donors after cardiac death. Transplant. Proc., 2010, 42, 7, p. 2407-2414. Go to original source... Go to PubMed...
    3. Matsuno, N., Sakurai, E., Kubota, K., Kozaki, K., Uchiyama, M., Nemoto, T. et al. Evaluation of the factors related to early graft function in 90 kidney transplants from non-heart-beating donors. Transplant. Proc., 1997, 29, 8, p. 3569-3570. Go to original source... Go to PubMed...
    4. Thornton, S. R., Hamilton, N., Evans, D., Fleming, T., Clarke, E., Morgan, J. et al. Outcome of kidney transplantation from elderly donors after cardiac death. Transplant. Proc., 2011, 43, 10, p. 3686-3689. Go to original source... Go to PubMed...
    5. Reich, D. J., Hong, J. C. Current status of donation after cardiac death liver transplantation. Curr. Opin. Organ. Transplant., 2010, 15, 3, p. 316-321. Go to original source... Go to PubMed...
    6. Dubbeld, J., Hoekstra, H., Farid, W., Ringers, J., Porte, R. J., Metselaar, H. J. et al. Similar liver transplantation survival with selected cardiac death donors and brain death donors. Br. J. Surg., 2010, 97, 5, p. 744-753. Go to original source... Go to PubMed...
    7. Callaghan, C. J., Charman, S. C., Muiesan, P., Powell, J. J., Gimson, A. E., van der Meulen, J. H. P. et al. Outcomes of transplantation of livers from donation after circulatory death donors in the UK: a cohort study. BMJ Open, 2013, 3, 9, p. e003287. Go to original source... Go to PubMed...
    8. Salvalaggio, P. R., Davies, D. B., Fernandez, L. A., Kauf-man, D. B. Outcomes of pancreas transplantation in the United States using cardiac-death donors. Am. J. Transplant. Off. J. Am. Soc. Transplant. Am. Soc. Transpl. Surg., 2006, 6, 5, p. 1059-1065. Go to original source... Go to PubMed...
    9. De Vleeschauwer, S. I., Wauters, S., Dupont, L. J., Verleden, S. E.,Willems-Widyastuti, A., Vanaudenaerde, B. M. et al. Medium-term outcome after lung transplantation is comparable between brain-dead and cardiac-dead donors. J. Heart Lung Transplant. Off. Publ. Int. Soc. Heart Transplant., 2011, 30, 9, p. 975-981. Go to original source... Go to PubMed...
    10. De Oliveira, N. C., Osaki, S., Maloney, J. D., Meyer, K. C., Kohmoto, T., D'Alessandro, A. M. et al. Lung transplantation with donation after cardiac death donors: long-term follow-up in a single center. J. Thorac. Cardiovasc. Surg., 2010, 139, 5, p. 1306-1315. Go to original source... Go to PubMed...
    11. Boucek, M. M., Mashburn, C., Dunn, S. M., Frizell, R., Edwards, L., Pietra, B. et al. Pediatric Heart Transplantation after Declaration of Cardiocirculatory Death. N. Engl. J. Med., 2008, 14, 359, 7, p. 709-714. Go to original source... Go to PubMed...
    12. Doporučení představenstva ČLK č. 1/2010. Dostupné na www: http://www.lkcr.cz/doc/cms_library/dop-1-2010-31.pdf
    13. Kootstra, G., Daemen, J. H., Oomen, A. P. Categories of non-heart-beating donors. Transplant. Proc., 1995, 27, 5, p. 2893-2894.
    14. Kootstra, G., Kievit, J. K., Heineman, E. The non heart-beating donor. Br. Med. Bull., 1997, 53, 4, p. 844-853. Go to original source... Go to PubMed...
    15. Wijdicks, E. F. M., Hijdra, A., Young, G. B., Bassetti, C. L., Wiebe, S. Quality Standards Subcommittee of the American Academy of Neurology. Practice parameter: prediction of outcome in comatose survivors after cardiopulmonary resuscita-tion (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 2006, 25, 67, 2, p. 203-210. Go to original source... Go to PubMed...
    16. Truog, R. D., Brock, D. W., White, D. B. Should patients re-ceive general anesthesia prior to extubation at the end of life? Crit. Care. Med., 2012, 40, 2, p. 631-633. Go to original source... Go to PubMed...
    17. Wind, J., Faut, M., van Smaalen, T. C., van Heurn, E. L. Variability in protocols on donation after circulatory death in Europe. Crit. Care Lond. Engl., 2013, 3, 17, 5, p. R217. Go to original source... Go to PubMed...
    18. Levvey, B. J., Westall, G. P., Kotsimbos, T., Williams, T. J., Snell, G. I. Definitions of warm ischemic time when using controlled donation after cardiac death lung donors. Transplantation, 2008, 27, 86, 12, p. 1702-1706. Go to original source... Go to PubMed...
    19. Hoffenberg, R. Christiaan Barnard: his first transplants and their impact on concepts of death. BMJ, 2001, 22, 323, 7327, p. 1478-1480. Go to original source... Go to PubMed...
    20. Zamperetti, N., Bellomo, R., Ronco, C. Defining death in non-heart beating organ donors. J. Med. Ethics., 2003, 29, 3, p. 182-185. Go to original source... Go to PubMed...
    21. Salen, P., Melniker, L., Chooljian, C., Rose, J. S., Alteveer, J., Reed, J. et al. Does the presence or absence of sonographically identified cardiac activity predict resuscitation outcomes of cardiac arrest patients? Am. J. Emerg. Med., 2005, 23, 4, p. 459-462. Go to original source... Go to PubMed...
    22. Hornby, K., Hornby, L., Shemie, S. D. A systematic review of autoresuscitation after cardiac arrest. Crit. Care Med., 2010, 38, 5, p. 1246-1253. Go to original source... Go to PubMed...
    23. Stiegler, P., Sereinigg, M., Puntschart, A., Seifert-Held, T., Zmugg, G., Wiederstein-Grasser, I. et al. A 10min "no-touch" time - is it enough in DCD? A DCD animal study. Transpl. Int. Off. J. Eur. Soc. Organ. Transplant., 2012, 25, 4, p. 481-492. Go to original source... Go to PubMed...
    24. Zákon č. 44/2013 Sb. Dostupné na www: http://www.mzcr.cz/Legislativa/dokumenty/zakon-c44/2013-sb-kterym-se-meni-zakon-c285/2002-sb-o-darovaniodberech_7543_2439_11.html
    25. Příloha č. 3 k vyhlášce č. 114/2013 Sb. Available from: http://www.zakonyprolidi.cz/cs/2013-114
    26. Joffe, A. R., Carcillo, J., Anton, N., deCaen, A., Han, Y. Y., Bell, M. J. et al. Donation after cardiocirculatory death: a call for a moratorium pending full public disclosure and fully informed consent. Philos Ethics Humanit. Med. (PEHM), 2011, 6, 17. Go to original source... Go to PubMed...
    27. Truog, R. D., Miller, F. G. Counterpoint: are donors after circulatory death really dead, and does it matter? No and not really. Chest, 2010, 138, 1, p. 16-18, discussion p. 18-19. Go to original source... Go to PubMed...
    28. Bernat, J. L. The debate over death determination in DCD. Hastings Cent. Rep., 2010, 40, 3, p. 3. Go to original source... Go to PubMed...
    29. Bernat, J. L. Point: are donors after circulatory death really dead, and does it matter? Yes and yes. Chest, 2010, 138, 1, p. 13-16. Go to original source... Go to PubMed...

    Return to the content


    Anesteziologie a intenzivní medicína

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.