Organ donations must take place within 60 minutes of when the heart stops beating. Coma patients and other people with irreversible brain injuries are often potential organ donors because their other organs are usually healthy.
“Neurologists must often predict whether the patient will be a candidate for organ donation, but the existing tools are not designed for people with critical brain disease or they require the patient to be taken temporarily off ventilator support to conduct the test,” said study author Alan Yee, DO, of the Mayo Clinic in Rochester, Minnesota. “This new test is a significant improvement because it can be conducted before the patient is taken off breathing support and is designed for people with critical brain disease.”
For the study, Yee and his colleagues analyzed the information from all patients during a seven-year period from the neurologic intensive care unit at the Mayo Clinic whose life support was withdrawn. Those who were brain dead or who did not have support for breathing were not included in the study.
A total of 149 comatose people were included in the study. After the withdrawal of life support, the heart stopped beating within 60 minutes for 75 people.
The study identified four factors that make it more likely that a person with irreversible brain damage will be a candidate for organ donation. The four factors are: no corneal reflex, no cough reflex, no motor response or extensor motor response, and high scores on the oxygenation index.
For the corneal reflex, people blink when the cornea is touched with a small piece of cotton or dripping water solution. People who do not have a corneal reflex are more likely to be candidates. People who do not have a cough reflex also are more likely to be candidates. For the cough reflex test, a chemical irritant is placed near the patient to see if the cough reflex will expel the irritant.
Responses to painful stimulation can also be tested. People who have no motor movements in response to pain and people who have extensor movements on their own or in response to pain are also more likely to be candidates for organ donation. Extensor motor response is a reflex movement of straightening the arms and legs.
People who have a score of greater than 4.2 on the oxygenation index, which is a test of how well the lungs are functioning, are also more likely to be good candidates for organ donation.
The study found that people with all four factors were 93 percent more likely to die within 60 minutes of withdrawal of life support than people with none of the factors. People with one of the four factors were 65 percent to 76 percent more likely to die within 60 minutes.
“This research will need to be validated with further studies, but it would be a valuable tool that could help improve organ donation rates after cardiac death and also help optimize the allocation of medical resources,” said Yee.
Study co-author Eelco Wijdicks, MD, also with the Mayo Clinic, is an author of a guideline on brain death that will be issued by the American Academy of Neurology in June.
The American Academy of Neurology, an association of more than 22,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as multiple sclerosis, restless legs syndrome, Alzheimer’s disease, narcolepsy and stroke.
For more information about the American Academy of Neurology, visit http://www.aan.com.VIDEO: http://www.youtube.com/AANChannel
Rachel L. Seroka | American Academy of Neurology
Multi-year study finds 'hotspots' of ammonia over world's major agricultural areas
17.03.2017 | University of Maryland
Diabetes Drug May Improve Bone Fat-induced Defects of Fracture Healing
17.03.2017 | Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke
Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.
The results will be published on March 22 in the journal „Astronomy & Astrophysics“.
Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...
Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.
Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...
In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...
20.03.2017 | Event News
14.03.2017 | Event News
07.03.2017 | Event News
24.03.2017 | Materials Sciences
24.03.2017 | Physics and Astronomy
24.03.2017 | Physics and Astronomy