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<p>We report the case of a&#xa0;young patient with severe hypoxic brain injury after cardiopulmonary resuscitation, resulting in brain death/death by neurologic criteria (BD/DNC). Consistent with the patient’s expressed wishes, treatment was sustained to facilitate organ donation. However, in the context of a&#xa0;severe post-resuscitation syndrome and physiological disturbances resulting from BD/DNC, refractory circulatory shock ensued. Stabilization was only possible by mechanical circulatory support (MCS). By implementation of MCS for extracorporeal organ support (ECOS), successful organ donation was rendered possible. Further debate is required concerning ethical issues, particularly concerning resource distribution, the timing of ECOS in relation to the diagnosis of BD/DNC and concerning specific consent for the invasive procedure. Until guidelines are presented, we believe that ECOS should be considered in the management of select potential donors in severe shock even before, and certainly after the diagnosis of BD/DNC.</p>

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Extrakorporale Organunterstützung als Überbrückungsstrategie zur Ermöglichung einer Organspende – eine Kasuistik mit Literaturübersicht

  • 期刊论文

  • 发表日期：

    2025年1月23日

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  • Esther Tautz,
  • Tobias Wengenmayer,
  • Dawid L. Staudacher,
  • Wolf Niesen,
  • Jürgen Bardutzky,
  • Laura Heine,
  • Michael Lücking,
  • Johann Lambeck

摘要

We report the case of a young patient with severe hypoxic brain injury after cardiopulmonary resuscitation, resulting in brain death/death by neurologic criteria (BD/DNC). Consistent with the patient’s expressed wishes, treatment was sustained to facilitate organ donation. However, in the context of a severe post-resuscitation syndrome and physiological disturbances resulting from BD/DNC, refractory circulatory shock ensued. Stabilization was only possible by mechanical circulatory support (MCS). By implementation of MCS for extracorporeal organ support (ECOS), successful organ donation was rendered possible. Further debate is required concerning ethical issues, particularly concerning resource distribution, the timing of ECOS in relation to the diagnosis of BD/DNC and concerning specific consent for the invasive procedure. Until guidelines are presented, we believe that ECOS should be considered in the management of select potential donors in severe shock even before, and certainly after the diagnosis of BD/DNC.