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Dtsch Med Wochenschr 2021; 146(16): 1077-1084
DOI: 10.1055/a-1004-6781
Übersicht

Die Organspende als Option in der intensivmedizinischen Behandlung am Lebensende

Organ donation: A treatment option in end-of life intensive care?
Klaus Michael Lücking
,
Gerold Söffker
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Die Transplantation solider Organe hat sich längst zu einer Standardtherapie des irreversiblen Endorganversagens von Herz, Lunge, Leber, Pankreas und Nieren entwickelt. Limitierender Faktor ist der gravierende Mangel an postmortal gespendeten Organen. Eine Schlüsselrolle in der Organspende haben die Intensivteams inne. In diesem Beitrag geht es um die Erkennung potenzieller Organspender, die Therapiezielfindung sowie eine leitlinienbasierte „organprotektive“ Intensivtherapie.

Abstract

A newly issued policy statement of the German Medical Association considers organ donation as an integral part of end-of-life intensive care in patients with devastating brain afflictions. Hence, patients’ wishes towards organ donation and medical suitability should be evaluated when prognosis is considered futile and goals of treatment need to be reconsidered. Continuation of intensive care treatment towards the (mandatory) diagnosis of “brain death” and subsequently towards organ donation has to be legitimatized by patients’ explicit wishes (organ donor card, advanced directive) or by surrogate decisions makers. Intensive care facilitating organ donation should be goal-directed and follow established guidelines. Thus, a potential recovery of transplantable organs is supported by appropriate intensive care treatment. Decisions to employ extended intensive care options (like extracorporeal circulatory support or cardiopulmonary resuscitation) in potential organ donors should be carefully outbalanced with patients’ wishes, organ donation being considered an achievable goal and even potential frictions in medical teams.

Schlüsselwörter

Organspende - Intensivtherapie - Entscheidungsfindung

Key words

organ donation - intensive care - end-of-life decision making


Publication History

Article published online:
20 August 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
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