Somatic survival and organ donation among brain-dead patients in the state of Qatar

Saibu George,Merlin Thomas,Prem Chandra,Ahmed Abdussalam,Tasleem Raza,Husain Shabbir Ali,Wanis H Ibrahim

doi:10.1186/s12883-016-0719-8

Abstract

BackgroundThe Qatari law, as in many other countries, uses brain death as the main criteria for organ donation and cessation of medical support. By contrast, most of the public in Qatar do not agree with the limitation or withdrawal of medical care until the time of cardiac death. The current study aims to examine the duration of somatic survival after brain death, organ donation rate in brain-dead patients as well as review the underlying etiologies and level of support provided in the state of Qatar.MethodsThis is a retrospective study of all patients diagnosed with brain death over a 10-year period conducted at the largest tertiary center in Qatar (Hamad General Hospital).ResultsAmong the 53 patients who were diagnosed with brain death during the study period, the median and mean somatic survivals of brain-dead patients in the current study were 3 and 4.5 days respectively. The most common etiology was intracranial hemorrhage (45.3 %) followed by ischemic stroke (17 %). Ischemic stroke patients had a median survival of 11 days. Organ donation was accepted by only two families (6.6 %) of the 30 brain dead patients deemed suitable for organ donation.ConclusionThe average somatic survival of brain-dead patients is less than one week irrespective of supportive measures provided. Organ donation rate was extremely low among brain-dead patients in Qatar. Improved public education may lead to significant improvement in resource utilization as well as organ transplant donors and should be a major target area of future health care policies.

Highlights

The Qatari law, as in many other countries, uses brain death as the main criteria for organ donation and cessation of medical support
The current study aims to examine the duration of somatic survival after brain death, organ donation rate in brain-dead patients as well as review the underlying etiologies and level of support provided to these patients
Eligible patients for the study were individuals aged ≥18 years with confirmed brain death (defined by Hamad General Hospital Brain Death Criteria that was largely adopted from the American Academy of Neurology (AAN) criteria [7]) who were admitted to Hamad General Hospital during the study period

Summary

Introduction

The Qatari law, as in many other countries, uses brain death as the main criteria for organ donation and cessation of medical support. Regardless of the persisting function of other individual organs, whole brain death that results in permanent loss of brain function, loss of consciousness, cognition and respiratory drive is the hallmark of irreversible cessation of the function of the organism as a whole [2]. The survival of these patients post confirmation of brain death is termed as “somatic survival” and this is usually maintained with the help of breathing and or circulatory support.

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