Brain Tumors as a Cause of Brain Death: Experience of the Nine Autopsy in Brain Dead Cases

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IntroductionBrain tumors are one of the etiology of brain death and in some cases because of no pathologic diagnosis before brain death, organ donation is challenging and questionable. One way is ignoring the case from donation and the other way is trying to achieve pathologic diagnosis. Because of worldwide donor shortage for transplantation trying to find pathologic diagnosis seems to be helpful to decrease mortality in transplantation waiting list. Here we present our experience in the brain autopsy of brain dead cases with no diagnosis before brain death.MethodsIn the nine cases of brain death that the etiology was brain tumor with no pathologic confirmation we did brain autopsy after aorta clamping during the organ retrieval. After finding the tumor frozen section was done and reviewed by pathologist.ResultsTumors were diagnosed as one medulloblastoma, one meningioma, and one patient with a subarachnoid hemorrhage but no tumor, meningioma in 1 one, craniopharyngioma in one, astrocytoma in two, neurofibroma in one and glioblastoma in one. Organ transplant was cancelled if the frozen sections revealed a high-grade tumor. For all other results, the transplant was performed. If a medulloblastoma was confirmed, only the heart was transplanted. The duration of the delay for pathologic examination was 30 to 45 minutes. A total of 21 organs were donated that would otherwise have been rejected.ConclusionIt is worth performing an autopsy and frozen-section pathology examination to prevent losing potential organs from donors with brain tumors who are suspected of having a high-grade neoplasm but have no pathology or neuroradiology reports. This process is simple and has the potential to save lives.Organ Procurement Unit.

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