[Legal aspects of transplant and donation]. / Aspectos legales del trasplante y la donación.

The Spanish model of organ and tissue donation enjoys great prestige in the world medical sphere and has been the object of study and imitation in different countries. Part of this success is due to the fact that since the year 1979 different legal norms have been enacted that have regulated and facilitated donation. The current legislation on the donation and transplant of organs and tissues is based on the principles of the gratuity and confidentiality of the donation, indicating the need for facilitating the formation of organisations at the level of the autonomous communities and at the national level. It also contains the requisites for donation of both live donors and deceased donors, establishing the norms for certification of death due to cardiorespiratory arrest and due to the irreversible cease of brain functions.

[Transplant coordination and logistics of intra and extra-hospital cadaver donor tissue. "The Pamplona Model". Sequence of tasks performed from 1992-2006]. / Coordinación y logística del trasplante de tejidos de donantes de cadáver intra y extra-hospitalarios. "Modelo Pamplona". Cadena de actuación 1992-2006.

INTRODUCTION: Tissue and organ donations are the only option for many patients. Cerebral death (CD) facilitates this approach. However, hospitals that do not provide CD donors have to adapt in order to obtain donors, referred to as tissue donors (TD), who have died from cardiac arrest. OBJECTIVE: Is this paper it descripte the model for coordination and donation of intra and extra-hospital TD in the Autonomous Community of Navarra. It creats a program for detection, donation and extractions called the Pamplona Model, from 1992-2006. MATERIAL AND METHODS: In 1990, a transplant team was created by an Intensive Medicine Physician of HVC, INML and SOS-Navarra. In 1996, VCH Transplant Coordination is defined as a reference centre for the Tissue Transplant Programme in the Autonomous Community of Navarra. RESULTS: Consensus protocols for "intra and extra-hospital detection" of persons having died from cardiac arrest are developed: - Alerts from NHS-O hospitals, SOS-Navarra; judges and INML forensic pathologists. - Criteria for selection, search and contacts with relatives. - Alert serology, extraction and transport teams. - Logistics and distribution of tissue. - Agreed incentives: Economic, administrative and relevant regulations. CONCLUSIONS: The Pamplona Model, with the Virgen Del Camino hospital has made important contributions and is unique in the world. Intra and extra-hospital coordination of cadaver donor from a referred hospital, it is a scientific and organizational advance to have in it counts for the creation of extraction and transplant tissues teams.

[Legal aspects of toxicological care]. / Aspectos legales de la atención toxicológica.

The care of poisoned patients in the sphere of the hospital emergency services is an increasingly frequent phenomenon. Any patient, whether or not they die, who is subjected to medical care in the course of a poisoning generates certain obligations from the medical-legal point of view. This paper reviews the most frequent causes of medical care in living patients, or in those who have died because of a poisoning, the legal obligations that care gives rise to, and the suitable form for approaching and resolving these.

Late fatal right ventricular perforation as complication of permanent pacing leads.

Perforation of the right ventricle during placement of pacing electrodes is a well-documented complication. Most of these perforations occur intraoperatively and rarely cause symptoms. This case report describes a fatal cardiac perforation that occurred 10 days after implantation of a permanent cardiac pacemaker. This complication should be considered as one of the potential mechanisms responsible for the high rate of sudden death observed in paced patients during the first year after pacemaker implantation.