Approach of the Clinicians Practicing in Intensive Care Units to Brain Death Diagnosis and Training Expectations in Turkey: A Web-Based Survey Sibel Yilmaz Ferhatoglu a, *, Murat Ferhat Ferhatoglu b , and Alp Gurkan b a University of Health Sciences, Dr Siyami Ersek Cardiothoracic Surgery Training and Research Hospital, Department of Anesthesiology, Istanbul, Turkey; and b Okan University, Faculty of Medicine, General Surgery Clinic, Department of Transplantation, Istanbul, Turkey ABSTRACT Background. For health professionals, recognizing and diagnosing brain death is vital for the development of organ transplantation. However, cadaveric organ donation rates remain insufficient, and this problem has become one of the most serious obstacles in the treatment of end-organ failure. Objectives. This study examines the attitude and knowledge level of clinicians who practice in intensive care units (ICUs) concerning the determination of brain death and describes the hindrances in diagnosing brain death. Materials and Methods. A survey study was designed with 26 questions, including questions regarding the determination of characteristics of respondents’ trainings, prac- ticing preferences, and their knowledge and approach toward brain death diagnosis. Cli- nicians practicing in ICUs in Turkey were invited to the survey. Results. A total of 244 surveys were fully completed. Physicians working at the university hospitals or university-affiliated hospitals answered the basic knowledge questions about brain death more accurately (P < .001). Also, physicians employed in university or university-affiliated hospitals feel more capable in diagnosing brain death (P ¼ .002) and are more willing to receive education on the brain death issue (P < .001). Conclusion. There is a gap separating the practices suggested in guidelines and the daily practice of ICU clinicians working in state hospitals or private institutions. Academic or- ganizations producing and leading the education curricula may assist in informing ICU clinicians who should be trained. T HE definition of brain death is the absolute cessation of all functions of the brain, including brain stem [1]. After the original description of the brain death concept by Mollaret et al. [2], the meaning and acceptance of this concept have converted a critical issue in the evolution of the organ transplantation process [3]. Medical care for these patients becomes a tremendous economic burden [4]. Thus, recognizing and diagnosing brain death becomes vital for the number of patients waiting for organ transplantation, given insufficient organ donation rates [5]. Although regulations on brain death diagnosis vary in each country [6e9], the physicians’ hesitation to diagnose brain death and the lack of knowledge or education about brain death are the 2 most notable impediments in detecting the appropriate organ for transplant. The principal aim of the presented investigation was to examine the attitude of clinicians who practice in intensive care units (ICUs) and to assess the knowledge level of these clinicians concerning the determination of brain death. The *Address correspondence to Sibel Yilmaz Ferhatoglu, Department of Anesthesiology and Reanimation, University of Health Sciences Dr Siyami Ersek Training and Research Hospital, Sahrayı Cedid Mh. Ataturk Cd. No:36/11 Kadikoy/Istanbul, 34734 Turkey. Tel: (þ90) 505 260 0701. E-mail: sibelyf@yandex.com ª 2020 Elsevier Inc. All rights reserved. 230 Park Avenue, New York, NY 10169 0041-1345/20 https://doi.org/10.1016/j.transproceed.2020.05.023 Transplantation Proceedings, XX, 1e7 (2020) 1