Effects on organ donation of transition from apnoeic-oxygenation to radioisotope brain scanning to diagnose brain death in children

James Tibballs*, Sainath Raman and Peter Francis

We studied rates of cadaveric organ donation on transition from apnoeic-oxygenation to radioisotope brain perfusion scanning to diagnose brain death. We studied records of children who were organ donors and/or had Technetium Tc99m Exametazine brain scans over 1989-2018. Donation after Brain Death (DBD) commenced in 1989, Donation after Circulatory Death (DCD) in 2011. Brain scanning was adopted in 2002 and apnoeic-oxygenation abandoned in 2007. In total, 95 of 1930 children (4.9%) donated organs (81 DBD, 14 DCD). During 1989-2001, with brain death diagnosed by clinical tests including apnoeic-oxygenation, 40 of 1059 children (3.8%) donated organs at average 3.1/annum. During 2002-2007 when either apnoeic-oxygenation or scanning was used, 18 of 351 children (5.1%) donated organs at average 3.0/year. During 2008-2018 with scanning in lieu of apnoeic-oxygenation, 23 of 520 children (4.4%) donated organs at average 2.1/annum. The difference in DBD rate between eras was not significant (P=0.52). Of 77 children scanned, 65(84%) were diagnosed brain dead after 1 or 2 scans, and 29 (45%) of these donated organs. Of 12 children with limited brain perfusion (not brain dead), DCD proceeded in 8 (67%). DCD or DBD (death diagnosed by scanning) was performed during 2011-2018 in 35 of 370 children (9.5%) which is significantly more (P<0.0001) than DBD (death diagnosed by apnoeic-oxygenation) in 1989-2001. Transition from apnoeic-oxygenation to scanning to diagnose brain death did not change DBD and may facilitate DCD. Brain death can be diagnosed by radionuclide scanning in lieu of apnoeic-oxygenation.

Keywords:

Published on: Feb 26, 2021 Pages: 1-7

Full Text PDF Full Text HTML DOI: 10.17352/2640-7973.000017
CrossMark Publons Harvard Library HOLLIS Search IT Semantic Scholar Get Citation Base Search Scilit OAI-PMH ResearchGate Academic Microsoft GrowKudos Universite de Paris UW Libraries SJSU King Library SJSU King Library NUS Library McGill DET KGL BIBLiOTEK JCU Discovery Universidad De Lima WorldCat VU on WorldCat