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KMID : 1130620200160030480
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Journal of Clinical Neurology
2020 Volume.16 No. 3 p.480 ~ p.490
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Determination of Brain Death/Death by Neurologic Criteria in Countries in Asia and the Pacific
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Lewis Ariane
Liebman Jordan
Bakkar Azza
Kreiger-Benson Elana
Kumpfbeck Andrew
Shemie Sam D.
Sung Gene
Torrance Sylvia
Greer David
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Abstract
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Background and Purpose: We sought to 1) identify countries in Asia and the Pacific that have protocols for the determination of brain death/death by neurologic criteria (BD/DNC) and 2) review the similarities and differences of these protocols in different countries.
Methods: Between January 2018 and April 2019, we attempted to communicate with contacts in the 57 countries in Asia and the Pacific to determine if they had official national BD/DNC protocols. We reviewed and compared the identified protocols.
Results: We identified contacts for 40 (70%) of the 57 countries in Asia and the Pacific, and successfully communicated with 37 of them (93% of countries with contacts identified, 65% of countries in Asia and the Pacific). We found that 24 of the 37 countries had BD/DNC protocols. Two (13%) of the 16 protocols that provided a definition of death referred to brainstem death. Kazakhstan and Israel required only 1 examination to declare BD/DNC, while 10 (71%) of the other 14 protocols required 2 examinations separated by 6?48 hours. The prerequisites, clinical examination, apnea testing procedure, and indications for/selection of ancillary tests varied. Ancillary testing was required for all determinations of BD/DNC in five (21%) countries. Thirteen (54%) of the protocols included information about the time of death, while 12 (50%) of them provided instructions about discontinuation of organ support.
Conclusions: The protocols for conducting a BD/DNC determination vary markedly among countries in Asia and the Pacific. Since it is optimal to have internationally and intranationally consistent BD/DNC protocols, efforts should be made to harmonize protocols both within this region and worldwide.
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KEYWORD
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brain death, policy, death, Asia
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