Gepost in: Orgaandonatie

Critical synopsis and key questions in brain death determination

This thematic issue in Intensive Care Medicine subscribes to a fundamental medical principle: Brain death is death, and organ and tissue donation must be a priority. For all involved in declaring brain death, there is acceptance, resignation, compassion, support, and a deep humanistic appreciation that lives can be saved. Intensivists (with their respective academies and societies) have defned the practice, proposed clinical pathways, and introduced safeguards. After much refection in the 1960s–1980s, brain death determination has been medically settled for most nations worldwide. Te Harvard Criteria for Brain Death—legendary and lauded—are now outdated [1]. Guidelines from the American Academy of Neurology released in 1995 and 2010 have precisely defned irrevocable brain and brainstem damage, and the adult criteria have worked exceptionally well [2]. Worldwide variations on a common theme exist but with the worthy intention of preventing mistakes. Intensivists, and often neurointensivists and neurosurgeons, have developed expertise through apprenticeship. We can examine this practice more closely periodically by posing key questions.




Eelco F. M. Wijdicks


Intensive Care Med (2019) 45:306–309