Mort encéphalique pédiatrique, nouvelles recommandations diagnostiques

Paediatric organ procurement and transplantation activity represent less than 5% of the national activity. In children under two years of age, organ procurements are very low and demanding, but remain definitively essential. Different hurdles concerning specific traumatic aetiologies, parental objection, scarcity of compatible recipient, make the organ procurements rare and complicated. Previous guidelines on paediatric brain death (BD) raise some unresolved practical questions, which may negatively affect potential donor census. Transcranial Doppler examination in paediatric patients allow easier monitoring of blood velocity profiles in the cerebral arteries, and may influence confidence improvement in paediatric intensive care teams concerned by BD. By advocating iterative clinical and DTC confrontation, new guidelines from Agence de la Biomedecine enhances the clinical diagnostic of BD and help to simplify the confirmation tests, either by cerebral angiography or by two electroencephalograms separate by 4 hours, at any age.