title: The effect of brain death protocol duration on potential donor losses due to cardiac arrest.
abstract: The severe inflammatory reaction that occurs after brain death (BD) tends to amplify over time, contributing to cardiovascular deterioration and occurrence of cardiac arrest (CA). Our purpose is to evaluate the effect of BD protocol duration (BDPD) on potential donor losses due to CA.
  
  
  
  This retrospective analysis included potential donors reported during the period from May 2012 to April 2014. The risk of losses due to CA was analyzed to identify the chronological threshold at which the probability of loss due to CA increases.
  
  
  
  Three hundred and eighty-four potential donors were analyzed. There was a greater chance of CA after a 30-hour threshold (OR 1.67, 95% CI: 1.38-1.83), and the lowest risk of was identified for the range from 12 to 30 hours (OR 0.32, 95% CI: 0.19-0.52). Multivariate analysis identified the following variables as being associated with lower occurrence of CA: BDPD between 12 and 30 hours, management of a potential donor inside the intensive care unit, and the adherence to a goal-directed protocol.
  
  
  
  A long duration between the first clinical test for BD diagnosis and the procurement of organs may be an important risk factor for the occurrence of cardiac arrest in deceased potential donors.
authors.affiliation: Transplantation Center of Santa Catarina, Santa Catarina, Brazil. glauco.w@brturbo.com.br.|University of the Region of Joinville, Santa Catarina, Brazil. glauco.w@brturbo.com.br.
authors.forename: Glauco Adrieno
authors.identifier: 0000-0001-9581-7141
authors.initials: GA
authors.lastname: Westphal
authors.affiliation: University of the Region of Joinville, Santa Catarina, Brazil.
authors.forename: Tiago Amaral
authors.initials: TA
authors.lastname: Slaviero
authors.affiliation: University of the Region of Joinville, Santa Catarina, Brazil.
authors.forename: Artur
authors.initials: A
authors.lastname: Montemezzo
authors.affiliation: University of the Region of Joinville, Santa Catarina, Brazil.
authors.forename: Gabriel Torres
authors.initials: GT
authors.lastname: Lingiardi
authors.affiliation: University of the Region of Joinville, Santa Catarina, Brazil.
authors.forename: Fernanda Carolina Cani
authors.initials: FC
authors.lastname: de Souza
authors.affiliation: Transplantation Center of Santa Catarina, Santa Catarina, Brazil.
authors.forename: Tiago Costa
authors.initials: TC
authors.lastname: Carnin
authors.affiliation: Transplantation Center of Santa Catarina, Santa Catarina, Brazil.
authors.forename: Diego Roberto
authors.initials: DR
authors.lastname: Soares
authors.affiliation: University of the Region of Joinville, Santa Catarina, Brazil.
authors.forename: Alisson Hideto
authors.initials: AH
authors.lastname: Hachiya
authors.affiliation: University of the Region of Joinville, Santa Catarina, Brazil.
authors.forename: Letícia Lopes
authors.initials: LL
authors.lastname: Ferraz
authors.affiliation: Transplantation Center of Santa Catarina, Santa Catarina, Brazil.
authors.forename: Joel
authors.initials: J
authors.lastname: de Andrade
mesh_terms: D000328:Adult; D001926:Brain Death / Q000175:diagnosis / Q000503:physiopathology*; D002985:Clinical Protocols; D005260:Female; D006323:Heart Arrest / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000379:methods / Q000592:standards*
keywords: brain death; donor management; donor management goals; organ donor; organ transplantation; protocol duration