Ethical aspects of organ donation

Cilj istraživanja: Utvrditi jesu li bolesnici s oštećenjem mozga i rizikom nastanka smrti mozga liječeni u skladu sa stručnim preporukama, postupa li se pri utvrđivanju smrti mozga u skladu sa zakonskim propisima, s kojim se poteškoćama susreću zdravstveni djelatnici koji skrbe o potencijalnim darivateljima organa. Nacrt studije: Retrospektivna studija. Ispitanici i metode: Ispitanici su bolesnici s oštećenjem mozga poznatoga uzroka liječeni u JIL-u Klinike za anesteziologiju KBC-a Osijek od 1. 1. 2005. do 31. 12. 2015. godine, u kojih je dokazana smrt mozga. Relevantni podatci (uzrok kome, način liječenja, zapisi o provedenim testovima, potvrda o smrti, suglasnost za eksplantaciju) prikupljeni su iz povijesti bolesti. Rezultati: Smrt mozga dokazana je kod 130 ispitanika. U 68,46 % slučajeva uzrok je kome bilo spontano, a u 31 % traumatsko cerebralno krvarenje. Preko 90 % ispitanika bilo je pri dolasku u JIL u areflektičnoj komi. U svih je ispitanika smrt mozga potvrđena kliničkim testovima i cerebralnom scintigrafijom. Eksplantacija je izvršena u 70 % slučajeva. Uočen je pozitivan trend incidencije smrti mozga, bez promjena u trendu incidencije eksplantacija te negativan trend protivljenja darivanju organa. Zaključak: Svi ispitanici liječeni su u skladu sa stručnim smjernicama. U onih čije je stanje upućivalo na gubitak mozgovnih funkcija, smrt mozga dokazana je, sukladno zakonskim propisima, kliničkim testovima i cerebralnom scintigrafijom. Eksplantirani su darivatelji čiji su bližnji potpisali suglasnost. Regrutacija većega broja potencijalnih darivatelja i rjeđe protivljenje darivanju organa nije značajnije utjecalo na broj izvršenih eksplantacija.Objectives: To establish whether the patients with brain damage and the risk of brain death occurence have been treated according to professional recommendation, whether everything is done according to legislation in case of brain death, what kind of problems do medical workers who take care of potential organ donours encounter. Study outline: A retrospective study. Participans and methods: Examinees are patients with brain damage of a known cause treated at the ICU of the Anestesiology Clinic of the Clinical Hospital Centre Osijek (KBC Osijek) since 1 January 2005 until 31 December 2015, for whom the brain death was proven. The relevant data (coma cause, treatment course, the records of conducted tests, death certificate, the explantation consent) was collected from disease history. Results: Brain death was proven with 130 examinees. In 68,46 % of the cases coma cause was spontanious, and in 31 % of the cases coma cause was traumatic cerebral hemmorrhage. Over 90% of the examinees were in an areflexic coma upon the arrival to the ICU. With all the examinees brain death was proven by the clinical studies and cerebral scintigraphy. Explantation was done in 70% of the cases. A positive trend of brain death incidents was noticed, withous changes in the trend of explantation incidents and a negative trend of opposition to organ donation. Conclusion: All examinees were treated according to professional guidelines. In cases where the condition pointed to the loss of brain functions, brain death was proven, according to legislation, by clinical tests and cerebral scintigraphy. The explanted patients were donours whose families signed the consent. Enlisting a larger number of potential donours and a weaker opposition to the organ donation did not significantly affect the number of conducted explantations