9th Congress of the Andalucian Transplantation SocietyOrgan donationNon–Heart-Beating Donor Program: Results After 3 Years of Experience
Section snippets
Methods
Prospective observational study carried out from 2012 to 2014. We included all patients with extrahospitalary cardiopulmonary arrest (CPA) who did not respond to cardiopulmonary resuscitation (CPR) and fulfilled all clinical criteria (Table 1). At that moment, patients became a potential donor (PD), so the ER team continued with the CPR and moved them to our hospital in a maximum time of 90 minutes from the CPA to hospital arrival. When ER physicians diagnosed irreversible death in asystole, we
Results
From January 2012 to December 2014 we received 97 queries, of which 40 were activated as PD, 24 (60%) became AD, and 22 (55%) RD. We had only 2 family (8%) and no court refusals. In 2012, 10 patients were donors, 5 in 2013, and 7 in 2014. The out-hospital median time was 71 (interquartile range [IQR] 60–76) minutes, in-hospital 29 (26–34) minutes, cannulation 28 (24–33) minutes, and perfusion 135 (105–177) minutes. Fig 1 shows times of each RD and the evolution over 3 years. Eighteen tissues
Discussion
Our results shows the feasibility of an NHBD program in our city that could help to meet the organ demand for transplantation [6]. Patient profile allows obtaining various organs and tissues of 1 donor that could benefit multiple receivers. The development of an NHBD program with special effort toward a clear and structured protocol, with tight times and coordination of all professionals involved can achieve viable organs with progressively less ischemia time. Despite the suddenness of the
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Cited by (13)
Geographic Information System Analysis: Promoting the Organ Donation Process in Andalusia
2019, Transplantation ProceedingsCitation Excerpt :During this 11-year period (2006 to 2017), the rate of public acceptance of organ donation in Andalusia reached 83.3%. The success of the donation-transplant process depends on adequate awareness on the part of professionals, as well as the initiation of new programs [3–5]. Furthermore, the planning and implementation of public awareness campaigns can be very complex, particularly in regions as extensive as ours [6].
Similar Outcomes of Kidney Transplantations Using Organs From Donors After Cardiac Death and Donors After Brain Death
2018, Transplantation ProceedingsCitation Excerpt :There was no difference most likely because the number of transplants in the present study was small. Martin-Villan et al [10] reported that non–heart-beating donation is a useful program with a low refusal rate (8%), that there was an average of 1.45 organs per donor, and that the kidney was the most frequently donated organ. In Japan, it is necessary to formulate rules to reduce the number of refusals of DCD kidneys and increase the number of potential donors.
Short-term Results From a Training Program to Improve Organ Donation in Uncontrolled Donation After Circulatory Death
2018, Transplantation ProceedingsCitation Excerpt :Second, a specific logotype was designed to alert emergency health care professionals that in cases where cardiopulmonary resuscitation was ineffective and after treatment of all potentially reversible causes, the “chain of survival” [4] should be considered a “chain of opportunities.” This progression could help physicians and relatives understand that in worse-case scenarios, uDCD provides several significant opportunities: (1) the opportunity to respect a patient's right to serve as a donor; (2) an opportunity for relatives to transform this senseless situation into something hopeful for the future; (3) the opportunity to determine cause of death and identify preventable hereditary heart disease that may be present in a patient's immediate family; (4) not least important, the real life opportunity that uDCD provides patients waiting for an organ donation [1,2]. Given the positive response to this initiative, signs with this logotype were installed in ambulances and in places of high visibility to professionals at the EPES-061 headquarters (Fig 1).
Decisions after irreversible cardiopulmonary arrest: ends and opportunities
2017, Medicina IntensivaOrgan donation process after unsuccessful cardiopulmonary resuscitation
2017, Medicina Clinica