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Brain death in early infancy

S Ashwal1

  • 1Division of Pediatric Neurology, Loma Linda University Medical Center, CA 92354.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|November 1, 1993
PubMed
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Pediatric brain death determination follows established guidelines, ensuring accurate organ donation. Studies confirm adherence to criteria, supporting timely heart and other organ transplants in children.

Area of Science:

  • Pediatric critical care medicine
  • Neurology
  • Organ transplantation

Background:

  • Established guidelines exist for diagnosing brain death in pediatric patients.
  • Diagnosis requires coma, absent cranial nerve reflexes, and apnea.
  • Neurodiagnostic studies are recommended for children under one year.

Purpose of the Study:

  • To evaluate adherence to brain death diagnostic criteria in pediatric organ donors.
  • To assess the accuracy and timeliness of brain death determination and organ procurement.
  • To identify potential improvements in the pediatric organ donation process.

Main Methods:

  • Retrospective review of 52 pediatric heart donor patient records.
  • Analysis of clinical documentation for coma, reflexes, and apnea.

Related Experiment Videos

  • Review of neurodiagnostic studies: electroencephalograms (EEGs) and cerebral blood flow (CBF) studies.
  • Examination of apnea challenge test results.

    • Main Results:

    • All 52 patients met clinical criteria for brain death, confirmed by two physicians.
    • Apnea challenge tests were performed in 27 patients (mean PCO2 73.3 torr).
    • Electroencephalograms showed electrocerebral silence in 28/33 studies; cerebral blood flow studies indicated absent flow in 19/22.
    • Successful transplantation of hearts (52), livers (34), kidneys (15), and other organs.

    Conclusions:

    • Current criteria and procedures for determining brain death in pediatric organ donors are effectively utilized.
    • Accurate and timely diagnosis facilitates successful organ procurement for transplantation.
    • Recommending apnea challenge tests in all eligible patients could enhance donor yield.