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뇌사 확진을 위한 방사선 동위원소 뇌관류 스캔의 유용성

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Affiliated Author(s)
김형태조원현이상도전석길
Alternative Author(s)
Kim, Hyoung TaeCho, Won HyunYi, Sang DoZeon, Seok Kil
Journal Title
대한이식학회지
ISSN
1598-1711
Issued Date
2002
Abstract
In Korea, brain death was established by the law in year 2000 but organ procurements from brain dead donors have been performed before the law era under the social tacit approval. Contrary to expectations, organ transplantation from brain dead donor have been much decreased in the law era. Electroencephalogram (EEG) is mandatory to confirm brain death in Korea. However EEG has several shortcomings and EEG wave may persist several hours after declaration of brain death by other tests. Purpose: To evaluate the Significance of EEG and single photon emission computerized tomography (SPECT) as a confirming test of the brain death. Methods: Clinical records of 42 cadaveric donor and their kidney recipients were reviewed retrospectively. Flat EEG was declared by two board certified neurologist or nerosurgeon. Tc99m-ECD SPECT was done in recent 10 donors who didn't show flat EEG at 24 hours after declarartion of bratin death on clinical examination. And compared interval renal transplantation to the moment when serum creatinine level went down below 2.0 mg/dl. Results: Among 42 donors, 3 went to cardiac arrest while waiting flat EEG. And one another donor also went to cardiac arrest just after taking flat EEG. All the ten donors who took barin SPECT showed absence of cerebral blood flow. After showing circulatory arrest to the brain on SPECT another 3 to 23 hours were needed to get the flat EEG. There was no difference in interval between EEG only group (9.8 days) and EEG plus SPECT group (9.2 days). But the interval was prolonged in cardiac arrest group up to 20 days. Conclusion: We could get the falt EEG 3 to 23 hours after circulatory arrest to the brain on SPECT scan. While waiting to get flat EEG three donors went to cardiac arrest and kidneys from these cardiac arrest donor showed delayed graft function in all cases. Brain SPECT should be used as a confirming test of brain death.
Alternative Title
Significance of SPECT as a Confirming Test of the Brain Death
Department
Dept. of Surgery (외과학)
Dept. of Neurology (신경과학)
Dept. of Nuclear Medicine (핵의학)
Publisher
School of Medicine
Citation
김미선 et al. (2002). 뇌사 확진을 위한 방사선 동위원소 뇌관류 스캔의 유용성. 대한이식학회지, 16(2), 251–257.
Type
Article
ISSN
1598-1711
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/38402
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
1. School of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학)
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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