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Research Article

Tissue Donation after Withdrawal of Life-Sustaining Treatment as an Advanced Care Plan is One of the Options in End-of-Life Care

Chih-Chuan Hsieh1,2, Chiao-Zhu Li1,3, Meng-Chi Li1,2, Yun-Ju Yang1, Kun-Ting Hong1, Chi-Tun Tang1, Tzu-Tsao Chung1, Da-Tong Ju1, Chun-Chang Yeh4, Yuan-Hao Chen1 and Dueng-Yuan Hueng1*

1Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

2Department of Surgery, Zoying Branch, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan

3Department of Surgery, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan

4Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

*Corresponding Author:
Dueng-Yuan Hueng, M.D., Ph.D
Department of Neurological Surgery, Tri-Service General Hospital
National Defense Medical Center, 4F, No. 325, 2nd Sec.
Cheng-Kung Road, Neihu District, Taipei City, Taiwan
Tel: +886-2-8792-7177
E-mail: hondy2195@yahoo.com.tw

Received date: Aug 13, 2016; Accepted date: September 13, 2016; Published date: September 16, 2016

Citation: Hsieh CC, Li CZ, Li MC, Yang YJ, Hong KT, et al. (2016) Tissue Donation after Withdrawal of Life-Sustaining Treatment as an Advanced Care Plan is One of the Options in End-of-Life Care. J Palliat Care Med 6:282. doi:10.4172/2165-7386.1000282

Copyright: © 2016 Hsieh CC. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: Withdrawal of life-sustaining treatment (WLST) is an option in end-of-life of critical illness in a surgical/neurosurgical intensive care unit (SNICU). In addition to lessen the patient’s suffering and to comfort the surrogates’ grief, there is something meaningful, such as tissue donation, for others to pursue. Aim: The aim of this study is to investigate the relationship between surgical intervention and the willingness of patients and/or their surrogates to donate tissue after WLST. Design: Retrospective cohort study of 368 patients who died in a SNICU in the past 3 years Setting/participants: Twenty-eight adult patients had life-sustaining treatment withdrawn from a total of 368 patients. We analyzed patient demographics and time courses of WLST in SNICU using the Student t-test. Results: Fourteen patients (50%) received surgical interventions, and 19 patients (67.86%) were admitted due to neuro-critical diseases. Tissue procurement for donation is significantly higher in patients underwent surgery than patients without surgery (21% vs. 0%, P=0.041) after the scheduled WLST and consequent verification of cardiac death. Conclusions: Our study uniquely demonstrates that patients who underwent surgical intervention with sufficient time for bidirectional discussions between physicians and the patients’ families were more likely to have tissues donated after WLST. Importantly, tissue donation after WLST is one of the options for end-of-life care in advanced care plan of SNICU.

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