title: A 10min "no-touch" time - is it enough in DCD? A DCD animal study.
abstract: Donation after cardiac death (DCD) is under investigation because of the lack of human donor organs. Required times of cardiac arrest vary between 75s and 27min until the declaration of the patients' death worldwide. The aim of this study was to investigate brain death in pigs after different times of cardiac arrest with subsequent cardiopulmonary resuscitation (CPR) as a DCD paradigm. DCD was simulated in 20 pigs after direct electrical induction of ventricular fibrillation. The "no-touch" time varied from 2min up to 10min; then 30min of CPR were performed. Brain death was determined by established clinical and electrophysiological criteria. In all animals with cardiac arrest of at least 6min, a persistent loss of brainstem reflexes and no reappearance of bioelectric brain activity occurred. Reappearance of EEG activity was found until 4.5min of cardiac arrest and subsequent CPR. Brainstem reflexes were detectable until 5min of cardiac arrest and subsequent CPR. According to our experiments, the suggestion of 10min of cardiac arrest being equivalent to brain death exceeds the minimum time after which clinical and electrophysiological criteria of brain death are fulfilled. Therefore shorter "no-touch" times might be ethically acceptable to reduce warm ischemia time.
authors.affiliation: Department of Transplantation Surgery, Medical University of Graz, Graz, Austria.
authors.forename: Philipp
authors.initials: P
authors.lastname: Stiegler
authors.forename: Michael
authors.initials: M
authors.lastname: Sereinigg
authors.forename: Andreas
authors.initials: A
authors.lastname: Puntschart
authors.forename: Thomas
authors.initials: T
authors.lastname: Seifert-Held
authors.forename: Gerda
authors.initials: G
authors.lastname: Zmugg
authors.forename: Iris
authors.initials: I
authors.lastname: Wiederstein-Grasser
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Marte
authors.forename: Andreas
authors.initials: A
authors.lastname: Meinitzer
authors.forename: Tatjana
authors.initials: T
authors.lastname: Stojakovic
authors.forename: Michael
authors.initials: M
authors.lastname: Zink
authors.forename: Vanessa
authors.initials: V
authors.lastname: Stadlbauer
authors.forename: Karlheinz
authors.initials: K
authors.lastname: Tscheliessnigg
mesh_terms: D000818:Animals; D001926:Brain Death / Q000175:diagnosis*; D016887:Cardiopulmonary Resuscitation / Q000662:veterinary; D003643:Death; D004569:Electroencephalography / Q000662:veterinary; D006323:Heart Arrest / Q000503:physiopathology*; D013552:Swine; D014110:Touch; D052096:Warm Ischemia