Guidelines for maintenance of adult patients with brain death and potential for multiple organ donations: the Task Force of the Brazilian Association of Intensive Medicine the Brazilian Association of Organs Transplantation, and the Transplantation Center of Santa Catarina

Transplant Proc. 2012 Oct;44(8):2260-7. doi: 10.1016/j.transproceed.2012.07.019.


Introduction: The organ shortage for transplantation, the principal factor that increases waiting lists, has become a serious public health problem. In this scenario, the intensivist occupies a prominent position as one of the professionals that first has a chance to identify brain death and to be responsible for the maintenance of the potential deceased donor.

Objective: This report attempts to establish guidelines for care and maintenance of adult deceased donor organs guiding and standardizing care provided to patients with brain death.

Method: These guidelines were composed by intensivists, transplant coordinators, professionals from various transplant teams, and used transplant center. The formulated questions were forwarded to all members and recommendations were constructed after an extensive literature review selecting articles with the highest degree of evidence.

Results: Guidelines were developed in the form of questions reflecting frequent experiences in clinical intensive care practices. The main questions were: Is there an optimal interval for keeping organs of deceased donors viable? What actions are considered essential for maintaining deceased donors in this period? What are the limits of body temperature? How should the patient be warmed? Which laboratory tests should be performed? What is the collection interval? What are the limits in the laboratory and the capture scenario? What are the limits of blood pressure? When and how should one use catecholamines?

Conclusions: This pioneer project involved a multidisciplinary team working in organ transplantation seeking to provide treatment guidance to increase the number of viable organs from deceased adult donors.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Adult
  • Biomarkers / blood
  • Blood Pressure
  • Blood Pressure Determination / standards
  • Blood Volume
  • Body Temperature
  • Brain Death* / blood
  • Brain Death* / diagnosis
  • Brain Death* / physiopathology
  • Brazil
  • Carbon Dioxide / blood
  • Cardiotonic Agents / therapeutic use
  • Critical Care / standards*
  • Echocardiography / standards
  • Erythrocyte Transfusion / standards
  • Evidence-Based Medicine
  • Fluid Therapy / standards
  • Humans
  • Intracranial Pressure
  • Lactic Acid / blood
  • Organ Transplantation / standards*
  • Oxygen / blood
  • Rewarming / standards
  • Time Factors
  • Tissue Donors / supply & distribution*
  • Tissue Survival
  • Tissue and Organ Harvesting / standards*
  • Tissue and Organ Procurement / standards*
  • Vasoconstrictor Agents / therapeutic use


  • Biomarkers
  • Cardiotonic Agents
  • Vasoconstrictor Agents
  • Carbon Dioxide
  • Lactic Acid
  • Oxygen