Grant: Project Grant

For many patients with terminal heart, lung, liver and kidney disease, organ transplantation is the treatment of choice and most often their only hope for survival. Organs retrieved in patients after a process called the neurological death determination (NDD) represent the principal source of organs transplanted in Canada. To ensure appropriate care for such patients, and also for the potential benefit of patients in urgent need of an organ, it is of uttermost importance to accurately identify potential patients in a state of neurological death and to proceed in a humane, accurate, timely and cost-effective manner to NDD. Situations however happen when the physician can have difficulties to timely or accurately confirm neurological death because of important facial trauma or the use of medications, for example. In such situations, doctors have to rely on additional tests. Unfortunately, currently available tests in NDD raise particular diagnostic challenges where several tests on the same patient are often used, most of which are not recommended or imprecise and hard to interpret. This often lead to rejection of organ donors and loss of potential organs for transplantation. CT-perfusion has many of the characteristics of an ideal test for NDD but has not been rigorously studied for NDD. We propose to conduct a large Canadian multicenter diagnostic test study to rigorously validate CT-perfusion compared to complete clinical evaluation for NDD. This research study will inform the different stakeholders in the fields of neurocritical-care and organ donation regarding ways to improve the diagnosis of brain death by validating an ideal test to help doctors diagnose brain death. We hope that this study will, by improving the NDD process, help ensure the most appropriate care to patients with neurological death and thus minimize the loss of potential organs for transplantation.