TABLE 1.

Definition and examples of Maastrich classification

Maastricht Type	Definition	Example
Maastricht la	A sudden out-of-hospital unexpected circulatory arrest without any attempt of resuscitation by a medical team	55-year-old man found dead in a forest and then transferred by ambulance to the emergency department.
Maastricht lb	A sudden in-hospital unexpected circulatory arrest without any attempt of resuscitation by a medical team	70-year-old woman admitted to the internal medicine ward was found dead during her vital signs check.
Maastricht lla	A sudden out-of-hospital unexpected irreversible circulatory arrest with unsuccessful resuscitation by a medical team	45-year-old woman with a history of coronary artery disease, which is found responsive and then collapses during the prehospital assessment. She is brought back to the emergency room with cardiorespiratory resuscitation maneuvers but is declared dead in the hospital after unsuccessful treatment
Maastricht llb	A sudden in-hospital unexpected irreversible circulatory arrest with unsuccessful resuscitation by a medical team	40-year-old man admitted to the coronary intensive care unit for unstable angina suddenly becomes unresponsive and is immediately treated using cardiopulmonary resuscitation techniques unsuccessfully.
Maastricht III	Is a planned withdrawal of life-sustaining therapy and expected circulatory arrest in patients that do not meet the criteria for brain death.	20-year-old man admitted due to a drug overdose. He is found unresponsive and had severe anoxic brain injury on brain imaging. He does not progress in weaning from the ventilator, and his functional prognosis is abysmal. The patient does not meet brain death criteria due to a corneal reflex on assessment. The family is approached for goals of care discussion, and a decision is made to withdraw care. Circulatory death is expected as a consequence of withdrawing life-sustaining therapies.
Maastricht IV	Is an uncontrolled circulatory arrest after brain death has been diagnosed.	34-year-old woman admitted to the neurosurgical intensive care unit due to a ruptured berry aneurysm. She is diagnosed with brain death on day three and unexpectedly sustains an uncontrolled circulatory arrest after the diagnosis of brain death has been made.