DETECT is a simple tool that requires only two set parameters, collected multiple times a day from each patient in every intensive care unit, and that can remedy a deficit in the detection of patients with possible impending irreversible loss of brain function (ILBF).
Nevertheless, we do not intend to conclude that there is a problem with (non)recognition of the overall condition of the intensive care patients and their treatment (as therapy-limiting, prognosis assessments are in fact made), but rather that a link to the option of a potential organ donation is lacking. In fact, we are convinced that patients receive excellent intensive medical care. Unfortunately, for the reasons described in the article, this does not fundamentally include the question of organ donation. Additionally, transplant physicians are not necessarily the treating physicians. DETECT can help to close communication gaps here.
Our article (1) also describes the problem of “the absence of a legal presumption of willingness to donate unless the patient has made a prior statement of his/her willingness to do so, and the consequent absence of broad social agreement with regard to such a presumption”. The ongoing political and social taboo about the topic of organ donation, which makes organ donation an exception rather than the norm, makes it difficult to “take it into consideration” and to focus on the relevant patients in the intensive care units of German hospitals.
DETECT overcomes this main problem by automatically focusing on the few eligible patients from a large number of intensive care patients, with a reduction by a factor of 30 (for instance, only 200 of the almost 6 000 patients in the Dresden University Hospital would be considered). In our opinion, both this focus and the expanded detection of a rarely occurring diagnosis that includes the possibility of a potential organ donation determine the special value of our tool.
We are convinced that a tool like DETECT can give both intensive care physicians and transplant coordinator additional time to further optimize treatment for intensive care patients.
Footnotes
Conflict of interest statement:
Prof. Hugo has received consulting honoraria from Novartis, Chiesi, AstraZeneca, Hans BioPharma, Alexion, Boehringer Ingelheim, Bayer Vital, Hansa Chemie AG, Otsuka, Fresenius, Vifor Pharma, Ablynx, Mallincrodt, Takeda, and MSD, reimbursement for conference registration fees and travel expenses from Astellas, Alexion, Boehringer Ingelheim, Otsuka, and Amgen, speaking honoraria from Astellas, Alexion, Novartis, Otsuka, Chiesi, and Boehringer Ingelheim, and study support (third-party funds) from Astellas, Sanofi, and Boehringer Ingelheim.
References
- 1.Trabitzsch A, Pleul K, Barlinn K, et al. An automated electronic screening tool (DETECT) for the detection of potentially irreversible loss of brain function. Dtsch Arztebl Int. 2021;118:683–690. doi: 10.3238/arztebl.m2021.0307. [DOI] [PMC free article] [PubMed] [Google Scholar]