Definitions Flashcards
Eligible Death (5)
- Is 75 years old or less
- Is legally declared brain dead
- Weight 5 kg or greater
- BMI of 50 kg/m2 or less
- Has at least one system rule in (kidney, liver, heart or lung)
Eligible Death
Kidney R/O Criteria (7)
- Greater than 70 years old
- Age 50-69 years with history of type 1 diabetes for more than 20 years
- Polycystic kidney disease
- Glomerulosclerosis greater than or equal to 20% by kidney biopsy
- Terminal serum creatinine greater than 4.0 mg/dL
- Chronic renal failure
- No urine output for 24 hours or longer
Eligible Death
Liver R/O Criteria (6)
- Cirrhosis
- Macrosteatosis greater than or equal to 50% or fibrosis greater than or equal to stage II
- Terminal total bilirubin greater than or equal to 4 mg/dL
- Portal hypertension
- Fulminant hepatic failure
- Terminal AST/ALT greater than 700 U/L
Eligible Death
Heart R/O Criteria (12)
- Greater than 60 years old
- 45yo or older with a hx HTN or DM x1 for 10+years
- CABG
- History of coronary stent/intervention
- Current or pmh of MI
- Severe CAD supported by cardiac cath (>50 percent occlusion or 2+ vessel disease)
- Acute myocarditis or endocarditis
- Heart failure due to cardiomyopathy
- AICD/ Pacer
- Moderate to severe valve disease documented by echo or cardiac cath, or previous valve repair
- Serial echo results showing severe global hypokinesis
- Myxoma
- Congenital defects (surgically corrected or not)
Eligible Death
Lung R/O Criteria (10)
- Greater than 65 years old
- COPD
- Terminal PF ratio less than 250 mmHg
- Asthma (with daily prescription)
- Asthma is the cause of death
- Pulmonary fibrosis
- Previous lobectomy
- Multiple blebs documented on CT scan
- Pneumonia as indicated on CT, X-ray, bronchoscopy, or cultures
- Bilateral severe pulmonary contusions as per CT
Eligible Death
Overall Rule Out
-The donor goes to the operating room with intent to recover organs for transplant and all organs are deemed not medically suitable for transplant
-The donor exhibits any of the following active infections
Bacterial: tuberculosis, gangrenous bowel or perforated bowel or intra-
abdominal sepsis
Viral: HIV infection by serologic or molecular detection, rabies, reactive
hepatitis B surface antigen, retroviral infections including viral
encephalitis or meningitis, active herpes simplex, varicella
zoster, or cytomegalovirus viremia or pneumonia, acute epstein
barr virus (mononucleosis), West Nile virus infection, or SARS.
Fungal: active infection with cryptococcus, aspergillus, histoplasma,
coccidioides, active candidemia or invasive yeast infection
Parasites: active infection with trypanosoma cruzi (Chagas’), Leishmania,
strongyloides, or malaria (plasmodium sp.)
Prion: Creutzfeldt-Jacob disease
Eligible Death
General Exclusions
- Aplastic anemia, agranulocytosis
- Current malignant neoplasms, except non-melanoma skin cancers such as basal cell and squamous cell cancer and primary CNS tumors without evident metastatic disease
- Previous malignant neoplasms with current evident metastatic disease
- A history of melanoma
- Hematologic malignancies: leukemia, Hodgkin’s disease, lymphoma, multiple myeloma
- Active fungal, parasitic, viral, or bacterial meningitis or encephalitis
- No discernible cause of death
Imminent neurological death
Patient who meets both of the following criteria:
- Meets the eligible death definition with the exception that the patient has NOT been declared legally brain dead.
- Has a severe neurological injury requiring vent support who has no observed spontaneous breathing and is lacking at least two of the additional brain stem reflexes that follow:
o Pupillary reaction
o Response to iced caloric
o Gag Reflex
o Cough Reflex
o Corneal Reflex
o Doll’s eyes reflex
o Response to painful stimuli
What patient would not be able to meet Imminent neurological death criteria?
A patient who is unable to be assessed neurologically due to administration of sedation or hypothermia protocol does not meet the definition of an imminent neurological death.
