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To the Editor: Dr Antommaria and colleagues¹ characterized donation after cardiac death (DCD) policies in children's hospitals and evaluated variation among policies. Western standards are that transplantation of organs is possible only if the patient complies with the dead donor rule.² Organ procurement is possible after the donor's death and must not cause death. Internationally, it is accepted as a norm that an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions or (2) irreversible cessation of all functions of the entire brain, including brain stem, is dead.³ Irreversible means that the function cannot be restored by anyone under any circumstances.³

Because DCD usually takes place after withdrawal of life support, the circulatory arrest might well be reversible by cardiopulmonary resuscitation within a certain period of time. In case of organ donation, the loss of brain functioning should always be the underlying criterion of death. In . . . [Full Text of this Article]

Yorick J. de Groot, MD; Erwin J. O. Kompanje, PhD
e.j.o.kompanje@erasmusmc.nl
Department of Intensive Care
Erasmus MC University Medical Center
Rotterdam, the Netherlands

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Policies on Donation After Cardiac Death at Children's Hospitals: A Mixed-Methods Analysis of Variation
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