Moreover, organ viability decreases the longer a person is brain dead; 12% sustained a cardiac arrest while awaiting a second exam or after the second exam, making them ineligible for organ donation.
It also costs money, she adds: A repeat exam adds an extra day of intensive care resulting in additional costs of about a million dollars per year in the New York region alone. It is, she tells HealthLeaders Media, “postmortem care in the ICU.”
In 2010, the American Academy of Neurology updated its brain-death guidelines, which now call for only one brain-death examination. That should be the new standard, but it isn’t widely adopted. This study supports that approach and details the harm of waiting for a second exam. There is simply no benefit to a second exam, says Lustbader. Hospitals must now revise their policies to prevent such avoidable harm, she says. “This should be a wakeup call.”
An editorial in the same issue, by Gene Sung, MD, MPH, of the University of Southern California in Los Angeles, endorses her call to action: "This study helps build the case for a single competent brain death examination or ancillary study when the examination cannot be performed.”