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Second Brain Death Exam Unnecessary, Study Finds
Date:12/15/2010

By Jenifer Goodwin
HealthDay Reporter

WEDNESDAY, Dec. 15 (HealthDay News) -- Making families wait for a second exam to confirm a brain death diagnosis is not only unnecessary but may make it less likely that the family will agree to donate their loved one's organs, a new study finds.

Researchers reviewed records from the New York Organ Donor Network database of 1,229 adults and 82 children who had been declared brain dead. All of the people had died in New York hospitals over a 19-month period between June 2007 and December 2009.

Patients had to wait an average of nearly 20 hours between the first and second exam, even though the New York State Health Department recommends a six-hour wait, according to the study.

Not only did the second exam add nothing to the diagnosis -- not one patient was found to have regained brain function between the first and the second exam -- lengthy waiting times appeared to make families more reluctant to give consent for organ donation.

About 23 percent of families refused to donate their loved ones organs, a number that rose to 36 percent when wait times stretched to more than 40 hours, the investigators found.

The converse was also true: Consent for organ donation decreased from 57 percent to 45 percent as wait times were dragged out.

Though the research did not look at the causes of the refusal, for families, waiting around for a second exam means another emotionally exhausting, stressful and uncertain day waiting in an intensive care unit to find out if it's time to remove their loved one from life support, said study author Dr. Dana Lustbader, chief of palliative care at The North Shore LIJ Health System in Manhasset, N.Y.

At the same time, the patient's already precarious condition can further decrease the odds of organ donation occurring as waiting times go up. Organ viability decreases the longer a person is brain dead, Lustbader said.

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