Elsevier

Transplantation Proceedings

Volume 47, Issue 9, November 2015, Pages 2567-2569
Transplantation Proceedings

9th Congress of the Andalucian Transplantation Society
Organ donation
Non–Heart-Beating Donor Program: Results After 3 Years of Experience

https://doi.org/10.1016/j.transproceed.2015.09.050Get rights and content

Highlights

  • Non–heart-beating donor programs could help meet organ demands.

  • A clear and structured protocol can achieve viable organs.

  • The possibility of organ donation could help the family in the mourning process.

Abstract

Background

Non–heart-beating donation (NHBD) is a useful way to obtain organs and tissues. Therefore, since 2012 we have had an NHBD protocol in the metropolitan area of Seville. The aim of this work was to present the results obtained after 3 years of program.

Methods

Prospective observational study carried out from 2012 to 2014. We included all patients with an extrahospitalary sudden death who did not survive despite cardiopulmonary resuscitation, becoming a potential donors (PD). Variables included number of consultations, PD, allowed donor (AD), real donor (RD), and family or legal refusals; minutes of out-hospital care, in-hospital care, cannulation, and perfusion of the RD; and number of organs and tissues removed and viable proportion. Nonallowed donors were grouped according to the discarding cause.

Results

We received 97 consultations, of which 40 were performed as PD. Of these, 24 were AD (60%) and 22 RD (55%). There were only 2 family 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. Eighteen tissues and 43 organs were extracted, of which 32 were implanted (75%), with kidneys (96%) being more frequent. Nonallowed donors numbered 12 in 2012, 4 in 2013, and 1 in 2014, and out-hospital causes were the most frequent discard reason.

Conclusions

NHBD is a useful program in our city with a low refusal rate (8%), an average of 1.45 organs per donor, and kidney the most frequent organ.

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

References (7)

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