Organ donation Safe brain death diagnoses?

Organ Donation: Doctors often overstrained with brain death diagnoses?

02/20/2014

Brain death diagnoses are not always provided according to the guidelines in German hospitals. That reports „Southgerman newspaper“ (SZ), citing their existing documents. The German Organ Transplantation Foundation (DOS) warns of the consequences. Potential donors may raise further doubts about organ donation. Time and again there have been transplant scandals in the past. The donor numbers then reached their lowest point. However, brain death diagnostics has been considered safe so far. According to the SZ, even death certificates had to be corrected later due to incorrect diagnoses.

Disagreement among the medical profession about the type of diagnosis of brain death
In the past three years, a total of ten people have submitted brain damage diagnoses without compliance with the guidelines. It was in no case come to that a living organs were removed, reports Rainer Hess, CEO of the DOS, to the news agency „dpa“. Thus Hess confirms a report of the SZ, after which death certificates had to be corrected afterwards. The cause lies in insufficient training of doctors in the field of brain death diagnostics, writes the newspaper. Hess also confirms that physicians are sometimes divided over how exactly the brain death is to be determined.

For a brain death diagnosis, there are clear guidelines in Germany. This includes, among other things, that two qualified physicians independently of each other make the diagnosis and have to agree on it, the paper reports. In addition, all circumstances should be excluded, which only numb the brain like medication, coma, too low body temperature or poisoning. However, according to the report, brain death diagnoses were also made, even though the patient was recently anesthetized with strong analgesics. A respiratory arrest test was also not performed correctly.

The neurologist Hermann Deutschmann from the Nordstadt Hospital in Hannover is committed to improved brain death diagnostics. „Brain death diagnostics is one of the safest methods of all, if you follow the guidelines and have experience in this field, "he explains to the SZ. In 30 percent of the cases in which he was consulted as a second expert for brain death diagnostics, but he could not confirm the diagnosis.

Training the doctors must be improved in brain death diagnoses
Eugen Brysch, director of the German Foundation for Patient Protection, calls „Competence Team Brain Diagnostics“, which is to be settled at the Robert Koch Institute. The specialists could then be requested by the removal hospitals. It is now „Consistent action is called for, because the question of whether organs are taken from the living or the dead is at the heart of concerns among the population about organ donation“, Brysch told the news agency.

Hess of the DOS considers the representation of the faulty brain death diagnoses exaggerated and sees above all the consequences of such scandals. „I emphatically reject the general suspicion of false death findings.“ It had been ten cases in three years. Mistakes would be made everywhere, unfortunately also in transplants. „Only in two cases has it come to an organ removal. In other cases the control system worked. There has never been an organ harvesting from living people“, emphasizes Hess. „You can not say that the whole system fails. The described cases are cleared up.“

Last year, the number of organ donors dropped to 876. This corresponds to a decrease of 16 percent compared to 2012. The cause is mainly the transplant scandals. Reports of incorrect brain death diagnoses are unlikely to improve the situation. Nevertheless, it is important to draw attention to such serious grievances. It is to be hoped that the public pressure will help to improve the training of doctors with regard to brain death diagnosis. (Ag)