{"id":9038,"date":"2021-01-28T14:49:26","date_gmt":"2021-01-28T14:49:26","guid":{"rendered":"https:\/\/cdtrp.ca\/?p=9038"},"modified":"2023-11-21T16:34:29","modified_gmt":"2023-11-21T20:34:29","slug":"deppart-study","status":"publish","type":"post","link":"https:\/\/cdtrp.ca\/en\/deppart-study\/","title":{"rendered":"When Is Dead Really Dead? &#8211; The Death Prediction and Physiology after Removal of Therapy Study (DePPaRT Study)"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1216.8px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><div class=\"tm-grid-expand uk-child-width-1-1 uk-grid-margin uk-grid uk-grid-stack\">\n<div class=\"uk-first-column\">\n<h4 class=\"uk-panel uk-text-large uk-margin\"><strong>When Is Dead Really Dead?<\/strong><br \/>\nThe Death Prediction and Physiology after Removal of Therapy Study (<strong>DePPaRT Study<\/strong>)<\/h4>\n<p class=\"uk-panel uk-text-large uk-margin\">A new international study, led by Dr. Sonny Dhanani of the CHEO Research Institute, and <a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2022713\">published in the January 28 issue<\/a> of the <strong>New England Journal of Medicine<\/strong>, documents the physiology of the dying process. Working closely with the Canadian Donation and Transplantation Research Program, the research team asked over 600 families to allow their loved ones in the ICU to have their vital signs monitored during the dying process. This is the largest international study of its kind.ions from the Ottawa Hospital Research Institute.<\/p>\n<\/div>\n<\/div>\n<\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:30px;margin-bottom:30px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;border-color:#e0dede;border-top-width:1px;\"><\/div><\/div><div class=\"fusion-text fusion-text-2\"><div class=\"tm-grid-expand uk-child-width-1-1 uk-grid-margin uk-grid uk-grid-stack\">\n<div class=\"uk-first-column\">\n<h6 class=\"uk-panel uk-text-large uk-margin\"><strong>Why is a study like this important?<\/strong><\/h6>\n<blockquote>\n<p class=\"uk-panel uk-text-large uk-margin\">For families to choose organ donation when a loved one has died, they must be able to trust that death has really happened and that it is irreversible. Trust allows people to decide to donate at a time of grief and allows the medical community to feel comfortable opening a dialogue about donation. For donation after circulatory-determined death to be medically possible, death must be declared within a window of time after life sustaining measures are withdrawn. Yet, stories persist about people \u201ccoming back to life\u201d following a declaration of death, and there was little evidence to inform the medical understanding of dying.<\/p>\n<\/blockquote>\n<h6 class=\"uk-panel uk-text-large uk-margin\"><strong>What did the study find?<\/strong><\/h6>\n<blockquote>\n<p class=\"uk-panel uk-text-large uk-margin\">Dr. Dhanani and his team found that the classic \u201cflatline\u201d of death is not so straightforward. The study showed that cardiac activity often stops and re-starts several times during the dying process before it finally stops completely \u2013 but no one regained sustained circulation or consciousness, or came back to life. The study provides evidence to support the current standard to wait for 5 minutes after the heart stops before determining death and proceeding to organ donation.<\/p>\n<\/blockquote>\n<h6 class=\"uk-panel uk-text-large uk-margin\"><strong>How do you ask a family whose loved one is dying in the ICU to participate in a research study on organ donation?<\/strong><\/h6>\n<blockquote>\n<p class=\"uk-panel uk-text-large uk-margin\">DePPaRT was empowered by the support and perspectives of a family partner, Ms. Heather Talbot, a woman whose son became a donor after dying in a car accident. The Canadian Donation and Transplantation Research Program\u2019s Patient, Family and Donor Partnership Platform connected Heather with the DePPaRT team in 2015, and she took on the emotional challenges of joining as a consultant. Heather provided feedback from a family\u2019s perspective, contributing ideas on how to appropriately approach families of dying patients. Her ability to reflect on her experiences and apply them to the study was pivotal for the project\u2019s success. Her contributions helped achieve a family consent rate of 93% and dampened the team\u2019s fears of overstepping boundaries. Her son\u2019s gift of organ donation saved at least four lives and her involvement in DePPaRT is multiplying those gifts.<\/p>\n<\/blockquote>\n<h6 class=\"uk-panel uk-text-large uk-margin\"><strong>What is the take away for the public?<\/strong><\/h6>\n<blockquote>\n<p class=\"uk-panel uk-text-large uk-margin\">Families and health care teams can trust that when death is determined, it is safe to begin the organ donation process. DePPaRT study data can now be used to inform policy and guidelines for determining death for organ donation both nationally and internationally. Further work using the study data will allow donation and transplant teams to predict how long it will take patients to die after removing life-sustaining measures. Predicting a time of death would be immensely useful to coordinate a donation and improve how organs are allocated.<\/p>\n<\/blockquote>\n<h6 class=\"uk-panel uk-text-large uk-margin\"><strong>Who supported this study?<\/strong><\/h6>\n<blockquote>\n<p class=\"uk-panel uk-text-large uk-margin\">This research was funded by the Canadian Institutes of Health Research as part of the Canadian Donation and Transplantation Research Program, the CHEO Research Institute, and Karel Pavl\u00edk Foundation. The study was conducted in 20 intensive care units in Canada, the Czech Republic, and the Netherlands, with a team of 42 researchers including expert study design and data analysis contributions from the Ottawa Hospital Research Institute.<\/p>\n<\/blockquote>\n<\/div>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-background-color:#88a9c3;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1216.8px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_2_3 2_3 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:66.666666666667%;--awb-margin-top-large:0px;--awb-spacing-right-large:2.88%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:2.88%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-image-element \" style=\"text-align:center;--awb-caption-title-font-family:var(--h2_typography-font-family);--awb-caption-title-font-weight:var(--h2_typography-font-weight);--awb-caption-title-font-style:var(--h2_typography-font-style);--awb-caption-title-size:var(--h2_typography-font-size);--awb-caption-title-transform:var(--h2_typography-text-transform);--awb-caption-title-line-height:var(--h2_typography-line-height);--awb-caption-title-letter-spacing:var(--h2_typography-letter-spacing);\"><span class=\" fusion-imageframe imageframe-none imageframe-1 hover-type-none\"><img decoding=\"async\" width=\"1024\" height=\"576\" title=\"Random\" src=\"https:\/\/cdtrp.ca\/wp-content\/uploads\/2021\/01\/Random.png\" data-orig-src=\"https:\/\/cdtrp.ca\/wp-content\/uploads\/2021\/01\/Random-1024x576.png\" alt class=\"lazyload img-responsive wp-image-17346\" srcset=\"data:image\/svg+xml,%3Csvg%20xmlns%3D%27http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%27%20width%3D%271600%27%20height%3D%27900%27%20viewBox%3D%270%200%201600%20900%27%3E%3Crect%20width%3D%271600%27%20height%3D%27900%27%20fill-opacity%3D%220%22%2F%3E%3C%2Fsvg%3E\" data-srcset=\"https:\/\/cdtrp.ca\/wp-content\/uploads\/2021\/01\/Random-200x113.png 200w, https:\/\/cdtrp.ca\/wp-content\/uploads\/2021\/01\/Random-400x225.png 400w, https:\/\/cdtrp.ca\/wp-content\/uploads\/2021\/01\/Random-600x338.png 600w, https:\/\/cdtrp.ca\/wp-content\/uploads\/2021\/01\/Random-800x450.png 800w, https:\/\/cdtrp.ca\/wp-content\/uploads\/2021\/01\/Random-1200x675.png 1200w, https:\/\/cdtrp.ca\/wp-content\/uploads\/2021\/01\/Random.png 1600w\" data-sizes=\"auto\" data-orig-sizes=\"(max-width: 1024px) 100vw, (max-width: 640px) 100vw, 800px\" \/><\/span><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_3 1_3 fusion-flex-column fusion-flex-align-self-center\" style=\"--awb-bg-size:cover;--awb-width-large:33.333333333333%;--awb-margin-top-large:0px;--awb-spacing-right-large:5.76%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:5.76%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-center fusion-content-layout-column\"><div class=\"fusion-text fusion-text-3\"><p style=\"text-align: center;\"><span style=\"color: #ffffff;\"><strong>Heather and Jonathon Talbot<\/strong><\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"color: #ffffff;\">In 2009, after a tragic car accident, Jonathon died a hero, saving the lives of at least four others through organ donation.<\/span><\/p>\n<p style=\"text-align: center;\"><em><span style=\"color: #ffffff;\">(Photo courtesy Heather Talbot)<\/span><\/em><\/p>\n<\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-3 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-3 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1216.8px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-4 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-4\"><h4><strong>Quotes<\/strong><\/h4>\n<blockquote>\n<p>\u201cTo do this, we had to go into ICUs and monitor people as they were dying. This is a very personal experience. And here we were collecting data, sending it to a server, downloading it and having people review the vital signs \u2026 how things stopped and if they restarted. People were worried. Some physicians didn\u2019t want to do it. Some researchers felt uncomfortable. But we knew we should keep going when we met Heather.\u201d<\/p>\n<\/blockquote>\n<p>&#8211;<strong>Dr. Sonny Dhanani, MD<\/strong><br \/>\nDePPaRT Study Lead<br \/>\nInvestigator, CHEO Research Institute<br \/>\nChief Critical Care, CHEO<br \/>\nAssociate Professor, University of Ottawa<\/p>\n<blockquote>\n<p>\u201cThis is an outstanding example of the powerful impact that a national framework for collaborative team science can achieve. Through the Canadian Donation and Transplantation Research Program, we have brought together different research communities, patient, family and donor partners, stakeholder organizations, and health care professionals who take non-traditional paths to doing research. This has created new synergies and new knowledge that will help more Canadians become donors and more patients receive transplants.\u201d<\/p>\n<\/blockquote>\n<p><strong>-Dr. Lori West, MD, DPhil<\/strong><br \/>\nCanada Research Chair in Cardiac Transplantation, University of Alberta<br \/>\nDirector, Canadian Donation and Transplantation Research Program<br \/>\nOfficer of the Order of Canada (2020)<\/p>\n<blockquote>\n<p>\u201cOn behalf of the Canadian Institutes of Health Research (CIHR), I would like to congratulate CDTRP and the DePPaRT team on the publication of this important study. CIHR is very pleased to be supporting a national network like CDTRP that has been able to bring together multiple stakeholders in the transplant area. This study is an example of the impactful work collaborations such as this one can achieve that will lead to improved outcomes for Canadians waiting for transplants.\u201d<\/p>\n<\/blockquote>\n<p><strong>-Dr. Charu Kaushic, MSc, PhD<\/strong><br \/>\nScientific Director, CIHR Institute of Infection and Immunity<\/p>\n<blockquote>\n<p>\u201cOn behalf of Canadian Blood Services, I would like to congratulate Dr. Dhanani and the DePPaRT team on this impactful work recognized in this important publication. Public and professional trust in the death determination process is absolutely essential for organ donation to proceed. This important work will help to inform the national death determination clinical practice guideline currently being updated through work in partnership with the Health Canada Organ Donation and Transplantation Collaborative.\u201d<\/p>\n<\/blockquote>\n<p>&#8211;<strong>Ms. Peggy John<\/strong><br \/>\nActing Director, Organ and Tissue Donation and Transplantation, Canadian Blood Services<\/p>\n<\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:30px;margin-bottom:30px;width:100%;\"><div class=\"fusion-separator-border sep-double sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;border-color:#e0dede;border-top-width:1px;border-bottom-width:1px;\"><\/div><\/div><div class=\"fusion-text fusion-text-5\"><h4><strong>Media contacts<\/strong><\/h4>\n<\/div><div class=\"fusion-text fusion-text-6 awb-text-cols fusion-text-columns-2\" style=\"--awb-columns:2;--awb-column-spacing:1em;--awb-column-min-width:50px;\"><p><strong>Stayci Keetch<\/strong><br \/>\n<em>CHEO Research Institute<\/em><br \/>\nTalk or text 1-613-697-0969<br \/>\n<a href=\"mailto:Skeetch@CHEO.on.ca\">Skeetch@CHEO.on.ca<\/a><\/p>\n<p><strong>Media Relations<\/strong><br \/>\n<em>Canadian Institutes of Health Research<\/em><br \/>\n613-941-4563<br \/>\n<a href=\"mailto:mediarelations@cihr-irsc.gc.ca\">mediarelations@cihr-irsc.gc.ca<\/a><\/p>\n<\/div><div class=\"fusion-separator fusion-full-width-sep\" style=\"align-self: center;margin-left: auto;margin-right: auto;margin-top:30px;margin-bottom:30px;width:100%;\"><div class=\"fusion-separator-border sep-single sep-solid\" style=\"--awb-height:20px;--awb-amount:20px;border-color:#e0dede;border-top-width:1px;\"><\/div><\/div><div class=\"fusion-text fusion-text-7\"><h4><strong>For further information<\/strong><\/h4>\n<ul>\n<li>\u201cResumption of Cardiac Activity after Withdrawal of Life-Sustaining Measures\u201d by Dhanani et al., 2021 in <a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2022713\">NEJM<\/a><\/li>\n<li>The Canadian Donation and Transplantation Research Program: <a href=\"https:\/\/cdtrp.ca\/en\/\">LINK<\/a><\/li>\n<li>Presentation of the DePPaRT patient and family partnership at the 2020 CDTRP Patient, Family and Donor Research Forum: <a href=\"https:\/\/cdtrp.ca\/wp-content\/uploads\/2020\/11\/Research-101-Family-Caregiver-Focus.mp4\">LINK<\/a><\/li>\n<li>Fast Facts: Death Determination and Deceased Organ Donation <a href=\"https:\/\/cdtrp.ca\/wp-content\/uploads\/2021\/01\/Fast-Facts-Death-Determination-FEB2021.pdf\">LINK<\/a><\/li>\n<li>CIHI Snapshot: Annual Statistics on Organ Replacement in Canada 2010-2019 (published Dec 2020) <a href=\"https:\/\/www.cihi.ca\/sites\/default\/files\/document\/corr-dialysis-transplantation-donation-2010-2019-snapshot-en.pdf\">LINK<\/a><\/li>\n<li>\u201cEngaging family partners in deceased organ donation research\u2014a reflection on one team\u2019s experience\u201d in the <em>Canadian Journal of Anaesthesia<\/em> (2019). <a href=\"https:\/\/doi.org\/10.1007\/s12630-018-01287-3\">LINK<\/a><\/li>\n<li>The Canadian Critical Care Trials Group: <a href=\"https:\/\/ccctg.ca\/Programs\/DDePICt-Determination-of-Death-Practices-in-Intensive-Care-Resarch-Program.aspx\">LINK<\/a><\/li>\n<li>Learn more about Organ and Tissue donation and how to register your intent to donate: <a href=\"https:\/\/www.blood.ca\/en\/organs-tissues\">LINK<\/a><\/li>\n<li>Organ Donation and Transplantation System Progress Data Dashboard: <a href=\"https:\/\/professionaleducation.blood.ca\/en\/organes-et-tissus\/rapports\/system-progress-data-reporting#2019dashboard\">LINK<\/a><\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":6,"featured_media":9054,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,75],"tags":[],"class_list":["post-9038","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general","category-featured"],"_links":{"self":[{"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/posts\/9038"}],"collection":[{"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/comments?post=9038"}],"version-history":[{"count":23,"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/posts\/9038\/revisions"}],"predecessor-version":[{"id":26390,"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/posts\/9038\/revisions\/26390"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/media\/9054"}],"wp:attachment":[{"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/media?parent=9038"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/categories?post=9038"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cdtrp.ca\/en\/wp-json\/wp\/v2\/tags?post=9038"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}