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Consensus on general medical contraindications to organ donation?

1992; BMJ; Volume: 305; Issue: 6850 Linguagem: Inglês

10.1136/bmj.305.6850.406

0959-8138

S M Gore, W. John Armitage, J. D. Briggs, Alison Crombie, D L Easty, Charles Hinds, Neville V. Jamieson, P. Johnston, Stephen Large, E. Major,

Palliative Care and End-of-Life Issues

During 1989 and 1990 in England and Wales 453 bias between raters.In only four cases, including a MRC Biostatistics Unit, confirmed brain stem dead patients in intensive care neonate and a haemophilic patient, was there serious Cambridge CB2 2SRwere reported to a confidential audit' as having a disagreement (contraindicated versus transplantable).Sheila M Gore, senior general medical contraindication to organ donation.In The two raters had commented as follows: KI (1)-"I statistician 437 cases the contraindication was briefly specified.seldom used code 3 because in most cases the contra- Because the incidence of general medical contraindicaindication given could have been genuine.I have United Kingdom tions to organ donation varied very significantly by therefore used code 2 a fair number of times and it Transplant Support region in England-from 9% in Oxford and Wessex would be most interesting to know more about these Service, Bristol BS10OSND (24 out of 266 confirmed brain stem deaths) to 27% in patients as I suspect there are a significant number W John Armitage, senior the North East Thames region and East Anglia (65 out where a transplant surgeon would have felt the contrascientist of 237 confirmed brain stem deaths)'-we speculated indication was not genuine"; KI (2)-"When there wasRenal Unit, Western that there might be a lack of consensus among insufficient information I used code 2. It was perfectly Infirmary, Glasgow specialties on the medical contraindications to organ possible that given all the information I might have GIl 6NTdonation and disagreements also within specialties.We then regarded transplantation to be contraindicated, J Douglas Briggs, consultant investigated these possibilities and report here our but maybe the bottom line is that it is a relatively easy renal physician results.thing to discuss the doubtful cases with the transplant team and let it be a shared decision as to whether St Mary's Hospital, patients are offered for transplantation or not."London W2 iNY Methods