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A 10 min "no-touch" time - is it enough in DCD? A DCD Animal Study.
MedLine Citation:
PMID:  22348340     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Summary Donation after cardiac death (DCD) is under investigation because of the lack of human donor organs. Required times of cardiac arrest vary between 75 s and 27 min until the declaration of the patients' death worldwide. The aim of this study was to investigate brain death in pigs after different times of cardiac arrest with subsequent cardiopulmonary resuscitation (CPR) as a DCD paradigm. DCD was simulated in 20 pigs after direct electrical induction of ventricular fibrillation. The "no-touch" time varied from 2 min up to 10 min; then 30 min of CPR were performed. Brain death was determined by established clinical and electrophysiological criteria. In all animals with cardiac arrest of at least 6 min, a persistent loss of brainstem reflexes and no reappearance of bioelectric brain activity occurred. Reappearance of EEG activity was found until 4.5 min of cardiac arrest and subsequent CPR. Brainstem reflexes were detectable until 5 min of cardiac arrest and subsequent CPR. According to our experiments, the suggestion of 10 min of cardiac arrest being equivalent to brain death exceeds the minimum time after which clinical and electrophysiological criteria of brain death are fulfilled. Therefore shorter "no-touch" times might be ethically acceptable to reduce warm ischemia time.
Authors:
Philipp Stiegler; Michael Sereinigg; Andreas Puntschart; Thomas Seifert-Held; Gerda Zmugg; Iris Wiederstein-Grasser; Wolfgang Marte; Andreas Meinitzer; Tatjana Stojakovic; Michael Zink; Vanessa Stadlbauer; Karlheinz Tscheliessnigg
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-20
Journal Detail:
Title:  Transplant international : official journal of the European Society for Organ Transplantation     Volume:  -     ISSN:  1432-2277     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908516     Medline TA:  Transpl Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. Transplant International © 2012 European Society for Organ Transplantation.
Affiliation:
 Department of Transplantation Surgery, Medical University of Graz, Graz, Austria  Department of General Surgery, Medical University of Graz, Graz, Austria  Department of Neurology, Medical University of Graz, Graz, Austria  Division for Biomedical Research, Medical University of Graz, Graz, Austria  Department of Anaesthesiology, Medical University of Graz, Graz, Austria  Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria  Department of Anaesthesiology and Intensive Care, Krankenhaus der Barmherzigen Brüder St. Veit an der Glan, St. Veit an der Glan, Austria  Department of Internal Medicine, Medical University of Graz, Graz, Austria.
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