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Comment & Response
February 24, 2021

Organ Donation After Euthanasia Starting at Home Is Feasible—Reply

Author Affiliations
  • 1Division of Hepato-Pancreato-Biliary and Transplant Surgery, Department of Surgery, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
JAMA Surg. 2021;156(5):502-503. doi:10.1001/jamasurg.2020.6680

In Reply We appreciate the opportunity to respond to Sonneveld and Mulder concerning our recent article, “Evaluation of Liver Graft Donation After Euthanasia.”1 In their Letter to the Editor, Sonneveld and Mulder stated that in case of organ donation after euthanasia starting at home (ODEH) the patient is only sedated at home. However, this seems to be in contradiction with the literature they refer to in their Letter.2-4 In these studies, it is stated that after the sedation with midazolam, the patient was put under general anesthesia using propofol with subsequent endotracheal intubation before transport to the hospital. After arrival at the intensive care unit, the patient received thiopental and rocuronium in the dosages described in the Dutch euthanasia protocol. According to the literature, general anesthesia is in fact a medically induced coma.5 Therefore, we think that the term coma-inducing drug, to which Sonneveld and Mulder refer in their Letter, has been used correctly in our article.

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