Organ retrieval from a donor after circulatory arrest – case report and review

Česká verzia

Authors: Rusinová Kateřina ^1,2; Pokorná Eva ³; Vávra Václav ¹; Kusová Dagmar ¹; Janoušek Libor ⁴; Froněk Jiří ⁴; Stach Zdeněk ¹; Turčianský Martin ¹; Otáhal Michal ¹; Doležal Adam ¹; Černý David ²; Balík Martin ¹; Černý Vladimír ^5,6
Authors place of work: Klinika anesteziologie, resuscitace a intenzivní medicíny, 1. lékařská fakulta Univerzity Karlovy a Všeobecná fakultní nemocnice, Praha ¹; Ústav pro humanitní studia v lékařství, 1. lékařská fakulta Univerzity Karlovy, Praha ²; Oddělení odběru orgánů a transplantačních databází, Transplantacentrum, Institut klinickéa experimentální medicíny, Praha ³; Klinika transplantační chirurgie, Institut klinické a experimentální medicíny, Praha ⁴; Fakultní nemocnice Hradec Králové, Klinika anesteziologie, resuscitace a intenzivní medicíny, Hradec Králové ⁵; Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada ⁶
Published in the journal: Anest. intenziv. Med., 25, 2014, č. 4, s. 301-306
Category: Intensive Care Medicine - Review Article

Summary

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

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