• Ernest van Veen, Mathieu van der Jagt, Maryse C Cnossen, MaasAndrew I RAIRDepartment of Neurosurgery, Antwerp University Hospital and University of Antwerp, Edegem, Belgium., Inez D de Beaufort, David K Menon, Giuseppe Citerio, Nino Stocchetti, Wim J R Rietdijk, van DijckJeroen T J MJTJMDepartment of Neurosurgery, Leiden University Medical Center, Leiden, the Netherlands., KompanjeErwin J OEJODepartment of Intensive Care, Erasmus University Medical Center, Rotterdam, the Netherlands. e.j.o.kompanje@erasmusmc.nl.Department of Medical Ethics and Philosophy of Medicine, Erasmus University Medical Center, Rotterdam, the Netherl, and CENTER-TBI investigators and participants.
• Department of Intensive Care, Erasmus University Medical Center, Rotterdam, the Netherlands.
• Crit Care. 2018 Nov 16; 22 (1): 306.

BackgroundWe aimed to investigate the extent of the agreement on practices around brain death and postmortem organ donation.MethodsInvestigators from 67 Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study centers completed several questionnaires (response rate: 99%).ResultsRegarding practices around brain death, we found agreement on the clinical evaluation (prerequisites and neurological assessment) for brain death determination (BDD) in 100% of the centers. However, ancillary tests were required for BDD in 64% of the centers. BDD for nondonor patients was deemed mandatory in 18% of the centers before withdrawing life-sustaining measures (LSM). Also, practices around postmortem organ donation varied. Organ donation after circulatory arrest was forbidden in 45% of the centers. When withdrawal of LSM was contemplated, in 67% of centers the patients with a ventricular drain in situ had this removed, either sometimes or all of the time.ConclusionsThis study showed both agreement and some regional differences regarding practices around brain death and postmortem organ donation. We hope our results help quantify and understand potential differences, and provide impetus for current dialogs toward further harmonization of practices around brain death and postmortem organ donation.

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