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Evaluation of patients referred to brain death scintigraphy

M. Havel,D. Skoloudik,D. Novakova, P. Svec, P. Havranek, G. Havlova,O. Kraft, V Dedek, K. Bukovansky, R. Drozdkova,P. Sirucek

ANESTEZIOLOGIE A INTENZIVNI MEDICINA(2021)

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Abstract
Objective: The aim of this work is to analyse data of brain death scintigraphy examinations performed within one centre retrospectively. We focused on the differences between examined children and adults, including proportions of coma causes or organ donors. The cases with negative scintigraphic finding were further assessed. Design: Retrospective. Setting: Nuclear Medicine Department, University Hospital. Material and methods: A total of 320 patients between years 2003 and 2020 were examined (mean age 44 +/- 18 years, 207 men, 113 women). The group was divided according to age into patients under 18 years (40, Group A) and those with age higher than or equal to 18 years (280, Group B), these groups were compared for the causes leading to coma and for the rate of organ donors. Results: A finding demonstrating cerebral aperfusion was recorded at 95% of patients during the first examination. The groups differed significantly in the causes leading to coma, cerebrovascular accidents formed only 10 % of Group A, in contrast to Group B with dominating cerebrovascular accidents and trauma plus other external causes (48 %, 43 % respectively, P < 0.0001). There were also significant differences in the proportions of patients who were not organ donors, they were significantly more frequent in Group A (55 % vs. 11 %, P < 0.0001), they have different proportions of causes leading to coma, with minority of cerebrovascular accidents (13 %, P < 0.0001). Conclusion: Brain perfusion scintigraphy is an available and usable method standardized in the brain death diagnosis. There are differences in the proportions of coma causes and of subsequent organ donors to transplant in childhood and adulthood.
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Key words
brain death, perfusion imaging, radionuclide imaging, transplantation
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