Transcranial Doppler As Ancillary Testing for Pediatric Brain Death/Death by Neurologic Criteria: Retrospective Study of the Israel Transplant Organ Donor Registry, 2016–2024

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Key Points

To evaluate transcranial Doppler as an ancillary test for pediatric brain death determination and compare it with radionuclide brain perfusion scintigraphy.
Conducted a retrospective cohort study using the Israel Transplant Organ Donor Registry from 2016 to 2024.
Included patients under 18 years old meeting clinical criteria for brain death and undergoing TCD or RBPS tests.
Analyzed demographic data, brain injury etiology, and sensitivity of TCD and RBPS tests.
RBPS had a sensitivity of 99% for brain death determination, compared to TCD sensitivity of 76%.
Among patients with TCD findings inconsistent with brain death, eight later had a RBPS consistent with brain death.
No significant demographic or clinical differences were found between the TCD and RBPS groups.

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Retrospective trial compares TCD and RBPS sensitivity for brain death in pediatric patients, suggesting RBPS is more reliable.

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Cohen et al. (2026) studied this question.

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