![]() In the present study, all examinations were carried out by two experienced doctors (usually a neurologist, neurosurgeon, or neurointensivist) who belonged to the same institute and were uninvolved in the definitive treatment or transplantation process. All of these institutes have been designated as appropriate hospitals based on their ability to carry out brain death diagnosis and organ donation. All records are submitted by the emergency institutes that anonymously donate organs throughout Japan. According to this law, all brain‐dead, heart‐beating organ donors in Japan must be verified by council members delegated by the Japanese Ministry of Health, Labour and Welfare (MHLW). The Japanese organ donation process was established by national law in 1997. The apnea test should be the last in the test seriesĬonfirmation of the absence of neurological changes after 6 h (this does not mean that the second examination should be performed exactly 6 h later)Ī period of >6 h should be allowed for patients with secondary brain damage (e.g., after cardiopulmonary resuscitation) and in children ≥6 years of age Although the method for suspending mechanical ventilation is arbitrary, the administration of 100% oxygen before and during the test is essential) Patients in whom the cause of brain damage has been definitively diagnosed and in whom the nature of the damage has been judged to be irremediable despite all currently available treatment methods for the diseaseĬhildren 60 mmHg during suspension of mechanical ventilation in the apnea test. Patients in a deep coma and apneic as a result of organic brain damage ![]() After the completion of these tests, the donor is allowed to be prepared for organ donation. ![]() All tests are repeated 6 h later for confirmation. 1 According to the declaration of brain death for heart‐beating organ donors, at least two experienced doctors (usually a neurologist, neurosurgeon, or neurointensivist) who are uninvolved in the transplantation procedure must examine all donors with respect to the following parameters: deep coma (no response to painful stimuli) with a Glasgow Coma Scale score of 3, bilaterally fixed pupils >4 mm in diameter, totally absent light, corneal, ciliospinal, oculocephalic, vestibular, pharyngeal, and cough reflexes, tested separately on each side, an isoelectric electroencephalogram (EEG) for >30 min (continuous recording), and apnea as confirmed by the standard apnea test (final PaCO 2 of >60 mmHg). The official criteria for brain death were proposed in 1985 by the Brain Death Study Group sponsored by the Japanese Ministry of Health and Welfare (MHW) (Table 1). According to the official Japanese criteria, brain death is defined as the irreversible loss of all cerebral functions, including those of the brain stem and cerebral hemispheres. ![]()
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