{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T15:53:32Z","timestamp":1791129212335,"version":"4.1.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2011,10,7]],"date-time":"2011-10-07T00:00:00Z","timestamp":1317945600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2011,10,7]],"date-time":"2011-10-07T00:00:00Z","timestamp":1317945600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                        <jats:title>Introduction<\/jats:title>\n                        <jats:p>We studied whether the choice of timing of discussing organ donation for the first time with the relatives of a patient with catastrophic brain injury in The Netherlands has changed over time and explored its possible consequences. Second, we investigated how thorough the process of brain death determination was over time by studying the number of medical specialists involved. And we studied the possible influence of the Donor Register on the consent rate.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Methods<\/jats:title>\n                        <jats:p>We performed a retrospective chart review of all effectuated brain dead organ donors between 1987 and 2009 in one Dutch university hospital with a large neurosurgical serving area.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>A total of 271 medical charts were collected, of which 228 brain dead patients were included. In the first period, organ donation was discussed for the first time after brain death determination (87%). In 13% of the cases, the issue of organ donation was raised before the first EEG. After 1998, we observed a shift in this practice. Discussing organ donation for the first time after brain death determination occurred in only 18% of the cases. In 58% of the cases, the issue of organ donation was discussed before the first EEG but after confirming the absence of all brain stem reflexes, and in 24% of the cases, the issue of organ donation was discussed after the prognosis was deemed catastrophic but before a neurologist or neurosurgeon assessed and determined the absence of all brain stem reflexes as required by the Dutch brain death determination protocol.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusions<\/jats:title>\n                        <jats:p>The phases in the process of brain death determination and the time at which organ donation is first discussed with relatives have changed over time. Possible causes of this change are the introduction of the Donor Register, the reintroduction of donation after circulatory death and other logistical factors. It is unclear whether the observed shift contributed to the high refusal rate in The Netherlands and the increase in family refusal in our hospital in the second studied period. Taking published literature on this subject into account, it is possible that this may have a counterproductive effect.<\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/cc10481","type":"journal-article","created":{"date-parts":[[2011,11,1]],"date-time":"2011-11-01T19:52:43Z","timestamp":1320177163000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Remarkable changes in the choice of timing to discuss organ donation with the relatives of a patient: a study in 228 organ donations in 20 years"],"prefix":"10.1186","volume":"15","author":[{"given":"Yorick J","family":"de Groot","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hester F","family":"Lingsma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"van der Jagt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Bakker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan NM","family":"IJzermans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erwin JO","family":"Kompanje","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2011,10,7]]},"reference":[{"key":"9718_CR1","volume-title":"Advice brain death criteria","author":"Health Council of the Netherlands","year":"1974","unstructured":"Health Council of the Netherlands: Advice brain death criteria. 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The Hague: Health Council of the Netherlands; 2006. publication no. 2006\/04"},{"key":"9718_CR5","unstructured":"The Organ Donation Act[http:\/\/english.minvws.nl\/includes\/dl\/openbestand.asp?File=\/images\/Organdonation_tcm20-108343.pdf]"},{"key":"9718_CR6","doi-asserted-by":"publisher","first-page":"1177","DOI":"10.1097\/TP.0b013e3182180567","volume":"91","author":"EJ Kompanje","year":"2011","unstructured":"Kompanje EJ, de Groot YJ, Bakker J: Is organ donation from brain dead donors reaching an inescapable and desirable nadir?\n                           Transplantation 2011, 91: 1177-1180. 10.1097\/TP.0b013e3182180567","journal-title":"Transplantation"},{"key":"9718_CR7","doi-asserted-by":"publisher","first-page":"2536","DOI":"10.1111\/j.1600-6143.2010.03215.x","volume":"10","author":"RF Saidi","year":"2010","unstructured":"Saidi RF, Bradley J, Greer D, Luskin R, O'Connor K, Delmonico F, Kennealey P, Pathan F, Schuetz C, Elias N, Ko DS, Kawai T, Hertl M, Cosimi AB, Markmann JF: Changing pattern of organ donation at a single center: are potential brain dead donors being lost to donation after cardiac death?\n                           Am J Transplant 2010, 10: 2536-2540. 10.1111\/j.1600-6143.2010.03215.x","journal-title":"Am J Transplant"},{"key":"9718_CR8","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1001\/jama.286.1.71","volume":"286","author":"LA Siminoff","year":"2001","unstructured":"Siminoff LA, Gordon N, Hewlett J, Arnold RM: Factors influencing families' consent for donation of solid organs for transplantation.\n                           JAMA 2001, 286: 71-77. 10.1001\/jama.286.1.71","journal-title":"JAMA"},{"key":"9718_CR9","doi-asserted-by":"publisher","first-page":"b991","DOI":"10.1136\/bmj.b991","volume":"338","author":"AL Simpkin","year":"2009","unstructured":"Simpkin AL, Robertson LC, Barber VS, Young JD: Modifiable factors influencing relatives' decision to offer organ donation: systematic review.\n                           BMJ 2009, 338: b991. 10.1136\/bmj.b991","journal-title":"BMJ"},{"key":"9718_CR10","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1111\/j.1600-6143.2005.01130.x","volume":"6","author":"JR Rodrigue","year":"2006","unstructured":"Rodrigue JR, Cornell DL, Howard RJ: Organ donation decision: comparison of donor and nondonor families.\n                           Am J Transplant 2006, 6: 190-198. 10.1111\/j.1600-6143.2005.01130.x","journal-title":"Am J Transplant"},{"key":"9718_CR11","doi-asserted-by":"publisher","first-page":"2304","DOI":"10.1016\/j.transproceed.2009.06.039","volume":"41","author":"A Andres","year":"2009","unstructured":"Andres A, Morales E, Vazquez S, Cebrian MP, Nuno E, Ortuno T, Morales JM, Hernandez E, Gonzalez E, Gutierrez MJ, Hernandez A, Polanco N, Gutierrez E, Praga M: Lower rate of family refusal for organ donation in non-heart-beating versus brain-dead donors.\n                           Transplant Proc 2009, 41: 2304-2305. 10.1016\/j.transproceed.2009.06.039","journal-title":"Transplant Proc"},{"key":"9718_CR12","doi-asserted-by":"publisher","first-page":"84","DOI":"10.7182\/prtr.1.6.2.r51w123x42715130","volume":"6","author":"PA Niles","year":"1996","unstructured":"Niles PA, Mattice BJ: The timing factor in the consent process.\n                           J Transpl Coord 1996, 6: 84-87.","journal-title":"J Transpl Coord"},{"key":"9718_CR13","doi-asserted-by":"publisher","first-page":"754","DOI":"10.1097\/00005373-200210000-00023","volume":"53","author":"LA Siminoff","year":"2002","unstructured":"Siminoff LA, Lawrence RH: Knowing patients' preferences about organ donation: does it make a difference?\n                           J Trauma 2002, 53: 754-760. 10.1097\/00005373-200210000-00023","journal-title":"J Trauma"},{"key":"9718_CR14","doi-asserted-by":"publisher","first-page":"3466","DOI":"10.1016\/j.transproceed.2009.09.014","volume":"41","author":"E Sotillo","year":"2009","unstructured":"Sotillo E, Montoya E, Martinez V, Paz G, Armas A, Liscano C, Hernandez G, Perez M, Andrade A, Villasmil N, Mollegas L, Hernandez E, Milanes CL, Rivas P: Identification of variables that influence brain-dead donors' family groups regarding refusal.\n                           Transplant Proc 2009, 41: 3466-3470. 10.1016\/j.transproceed.2009.09.014","journal-title":"Transplant Proc"},{"key":"9718_CR15","doi-asserted-by":"publisher","first-page":"1992","DOI":"10.1093\/ndt\/gfp705","volume":"25","author":"NE Jansen","year":"2010","unstructured":"Jansen NE, van Leiden HA, Haase-Kromwijk BJ, Hoitsma AJ: Organ donation performance in the Netherlands 2005-08; 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