Chinese Journal of Neuromedicine 2024;23(4):392-396

doi:10.3760/cma.j.cn115354-20240417-00241

Clinical analysis of brain death determination in organ donors under veno-arterial extracorporeal membrane oxygenation assisted circulatory support

Songying SHEN 1 ; Meiyun JIA ; Hong WANG ; Yunfeng ZHAO ; Huijun DONG ; He ZHAO ; Wei QIN ; Xingsong QIN ; Meng ZHAO ; Yajie LIU ; Hongyu WANG

Affiliations

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Keywords

Extracorporeal membrane oxygenation; Organ donation; Brain death; Apnea test; Donor

Country

China

Language

Chinese

Abstract

Objective:To summarize the experience of brain death determination under veno-arterial extracorporeal membrane oxygenation (VA-ECMO) assisted circulatory support, especially apnea test (AT) precautions, and to provide references for brain death determination in this scenario.Methods:In 78 patients who had VA-ECMO at Organ Transplant Center, Zhengzhou People's Hospital from October 2019 to December 2023, 8 organ donors had brain death determination under VA-ECMO assisted circulatory support. Baseline data, clinical data, and VA-ECMO data during AT trial were collected from these 8 patients to summarize the process of brain death determination.Results:Six of the 8 donors met the criteria of brain death; 10 EEG, 12 evoked potentials and 15 ATs were performed. Complications in ATs, including hypotension, decreased oxygenation and arrhythmia, were alleviated after timely improved VA-ECMO flow and applied cardiotonic and pressor drugs.Conclusion:AT is key for successful brain death determination in organ donors under VA-ECMO assisted circulatory support; therefore, complications should be closely monitored and managed.