{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T08:07:52Z","timestamp":1770970072402,"version":"3.50.1"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T00:00:00Z","timestamp":1588636800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Amphetamine and its derivatives\u2019 consumption is still an important public health issue, namely in terms of compounds variability and disposition to consumers. However, some of them, like 3,4-methylenedioxymethamphetamine (MDMA), still live in the illicit market, with continuous success. Nevertheless, there is always new information and data on MDMA intoxication, both in vivo and in postmortem context. The authors report an intoxication case with MDMA, in an 18-year-old male, considered a potential organ donor after a cardiac arrest. Whole blood samples were collected in vivo, at the emergency room (ER), and postmortem, at the National Institute of Legal Medicine and Forensic Sciences. After a general screening procedure, samples were extracted by solid phase extraction (OASIS\u00ae MCX), followed by gas chromatography\u2013mass spectrometry analysis. The whole blood postmortem sample was positive for lidocaine (&amp;lt;500\u00a0ng\/mL), compatible with the ER intervention, and positive for MDMA (2278\u00a0ng\/mL) and methylenedioxyamphetamine (MDA) (49\u00a0ng\/mL), while whole blood samples collected in vivo (during the maintenance of the individual under advanced life support), were positive for MDMA (504\u20131918\u00a0ng\/mL) and MDA (20\u201389\u00a0ng\/mL). Samples were negative for other substances, namely ethanol, other drugs of abuse and medicines. Results interpretation is pivotal to understand the behavior of the substance. Thus, in this case, MDMA postmortem behavior should be carefully evaluated, considering as possible influencers, in the specific context of the case, the time lapse between death verification, maintenance of the advanced life support and body manipulation for organ collection purposes. Also referred and discussed is the antemortem\/postmortem ratio of MDMA obtained values, compared with literature references. There is no doubt that death was due to MDMA intoxication, but information from the analysis performed on the in vivo samples suggests that this type of sample should also be considered, in a complementary role, whenever possible.<\/jats:p>","DOI":"10.1093\/jat\/bkaa042","type":"journal-article","created":{"date-parts":[[2020,4,27]],"date-time":"2020-04-27T11:07:09Z","timestamp":1587985629000},"page":"923-926","source":"Crossref","is-referenced-by-count":6,"title":["MDMA Intoxication in a Potential Organ Donor with Cardiac Arrest"],"prefix":"10.1093","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7258-8523","authenticated-orcid":false,"given":"Andr\u00e9 L","family":"Castro","sequence":"first","affiliation":[{"name":"National Institute of Legal Medicine and Forensic Sciences, Forensic Chemistry and Toxicology Service, Jardim Carrilho Videira, 4050-067, Porto, Portugal"},{"name":"Abel Salazar Biomedical Sciences Institute, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal"}]},{"given":"S\u00f3nia","family":"Tarelho","sequence":"additional","affiliation":[{"name":"National Institute of Legal Medicine and Forensic Sciences, Forensic Chemistry and Toxicology Service, Jardim Carrilho Videira, 4050-067, Porto, Portugal"}]},{"given":"Dina","family":"Almeida","sequence":"additional","affiliation":[{"name":"Abel Salazar Biomedical Sciences Institute, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal"},{"name":"National Institute of Legal Medicine and Forensic Sciences, Forensic Clinical and Pathology Service, Jardim Carrilho Videira, 4050-067, Porto, Portugal"}]},{"given":"Lara","family":"Sousa","sequence":"additional","affiliation":[{"name":"National Institute of Legal Medicine and Forensic Sciences, Forensic Chemistry and Toxicology Service, Jardim Carrilho Videira, 4050-067, Porto, Portugal"}]},{"given":"Jo\u00e3o Miguel","family":"Franco","sequence":"additional","affiliation":[{"name":"National Institute of Legal Medicine and Forensic Sciences, Forensic Chemistry and Toxicology Service, Jardim Carrilho Videira, 4050-067, Porto, Portugal"}]},{"given":"Helena M","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Department of Research, Training and Documentation, National Institute of Legal Medicine and Forensic Sciences, Coimbra, Polo das Ci\u00eancias de Sa\u00fade (Polo III) - Azinhaga de Santa Comba 3000-548 Coimbra, Portugal"},{"name":"Faculty of Medicine, University of Coimbra, Polo das Ci\u00eancias de Sa\u00fade (Polo III) - Azinhaga de Santa Comba 3000-548 Coimbra, Portugal"}]}],"member":"286","published-online":{"date-parts":[[2020,5,5]]},"reference":[{"key":"2020121209234459700_ref1","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1093\/jat\/31.3.138","article-title":"Analysis of MDMA and its metabolites in urine and plasma following a neurotoxic dose of MDMA","volume":"31","author":"Valtier","year":"2007","journal-title":"Journal of Analytical Toxicology"},{"key":"2020121209234459700_ref2","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1053\/ajem.2003.50028","article-title":"Multiple toxicity from 3,4-Methylenedioxymethamphetamine (\u201cecstasy\u201d)","volume":"21","author":"Greene","year":"2003","journal-title":"American Journal of Emergency Medicine"},{"key":"2020121209234459700_ref3","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.resuscitation.2017.06.001","article-title":"Organ donation in cardiac arrest patients treated with extracorporeal CPR: a single centre observational study","volume":"118","author":"Casadio","year":"2017","journal-title":"Resuscitation"},{"key":"2020121209234459700_ref4","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1093\/jat\/30.8.545","article-title":"Distribution of methylenedioxymethamphetamine (MDMA) and methylenedioxyamphetamine (MDA) in postmortem and 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(\u2018ecstasy\u2019)","volume":"112\u2013113","author":"Maurer","year":"2000","journal-title":"Toxicology Letters"},{"key":"2020121209234459700_ref8","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.forsciint.2003.12.015","article-title":"Interpretation of a 3,4-methylenedioxymethamphetamine (MDMA) blood level: discussion by means of a distribution study in two fatalities","volume":"141","author":"De Letter","year":"2004","journal-title":"Forensic Science International"},{"key":"2020121209234459700_ref9","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.forsciint.2007.03.030","article-title":"Post-mortem cases involving amphetamine-based drugs in the Netherlands comparison with driving under the influence cases","volume":"170","author":"Verschraagen","year":"2007","journal-title":"Forensic Science 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