Assuntos
Suicídio Assistido , Obtenção de Tecidos e Órgãos , Humanos , Ambulâncias , Doadores de TecidosAssuntos
Reanimação Cardiopulmonar/instrumentação , Morte Súbita Cardíaca , Obtenção de Tecidos e Órgãos/métodos , Idoso , Reanimação Cardiopulmonar/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transplante de Órgãos/estatística & dados numéricos , Estudos Retrospectivos , Espanha , Doadores de Tecidos/estatística & dados numéricosAssuntos
Sobrevivência de Enxerto , Parada Cardíaca , Transplante de Fígado/mortalidade , Doadores de Tecidos/estatística & dados numéricos , Coleta de Tecidos e Órgãos/métodos , Obtenção de Tecidos e Órgãos/métodos , Adulto , Humanos , Transplante de Fígado/métodos , Transplante de Fígado/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde , Espanha , Coleta de Tecidos e Órgãos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/estatística & dados numéricosAssuntos
Oscilação da Parede Torácica/métodos , Morte , Transplante de Rim/métodos , Obtenção de Tecidos e Órgãos/métodos , Adulto , Estudos de Coortes , Seguimentos , Rejeição de Enxerto , Sobrevivência de Enxerto , Humanos , Transplante de Rim/mortalidade , Masculino , Pessoa de Meia-Idade , Valores de Referência , Medição de Risco , Taxa de Sobrevida , Fatores de Tempo , Doadores de Tecidos , Resultado do TratamentoRESUMO
Non-heart-beating donors (NHBDs) have to meet the predefined criteria for organ donation including death from irreversible cessation of the beating heart. The Maastricht conference defined 4 NHBD categories to differentiate their viability and ethical-legal support. In Spain, NHBDs who originate from an out-of-hospital setting correspond to type II donors. These are patients who have had a cardiac arrest outside hospital and, after failed CPR attempts, are transferred with hemodynamic support measures to the hospital for organ donation. The Hospital Clínico San Carlos also has a lung donation program in collaboration with the Hospital Puerta de Hierro in Madrid and the Hospital Marques de Valdecilla in Santander. The objective of this study is to describe the results of lung transplantation of after cardiac death program, specifically the section regarding lung extraction donation. Twenty potential lung donors were obtained during the study. Most patients were male (19 cases), with a mean age of 42 years (36.5-49.5 years). A total of 33 lungs were donated (18 right and 15 left lungs). Most extractions were multiorganic (19 cases). One liver, 19 kidneys, 2 pancreas, and 19 corneas were obtained from these donors; bone tissue was obtained from all donors. The transplantation was bipulmonary in 13 cases and unipulmonary in 7. Thirty days after transplantation, 2 recipients died, 1 died of stroke associated with bilateral pneumonia and 1 died of hypovolemic shock resulting from hemothorax. The remaining 18 patients were progressing well at 30 days. Our data suggest that lung transplantation from patients after extrahospitalary cardiac death is feasible.
Assuntos
Transplante de Pulmão , Doadores de Tecidos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/organização & administração , Adulto , Morte , Serviços Médicos de Emergência/organização & administração , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espanha , Resultado do TratamentoRESUMO
OBJECTIVE: The Medical Emergencies Service of Madrid (Spain) (Servicio de Urgencias Medicas de Madrid), SUMMA112, forms part of an organ donor program involving patients who have suffered out-hospital cardiac arrest and fail to respond to advanced cardiopulmonary resuscitation maneuvers. Subjects meeting the inclusion criteria are moved to a transplant unit under sustained resuscitation maneuvering in order to harvest the organs. This paper presents compliance with the timelines of the program, the proportion of donors, the characteristics of donors and non-donors, and the number of organs obtained. MATERIAL: A retrospective descriptive study was made based on the review of case histories. The SPSS(©) version 16.0 statistical package was used for data analysis. RESULTS: A total of 214 cases were recorded, of which 84% were males. The mean age was 40 years. The mean time to arrival on scene was 13 min and 34 s. The mean time to arrival in hospital was 88 min and 10 s. A total of 522 organs and tissues were harvested (250 kidneys, 33 livers, 123 corneas, 97 bone tissues and 19 lungs), corresponding to 3.2 organs/tissues per patient on average. A total of 21.7% of the patients were not valid. There were no differences between the valid and non-valid patients in terms of age and gender. The causes of non-donation included extracorporeal circuit failure (6.3%), family refusal (15.6%), patient refusal expressed in life (4.7%), legal denial (1.6%), biological causes (51.6%), and others (20.3%). Cardiac compressors were used in 85 cases, yielding 92 kidneys, 41 corneas, 30 bone tissues, 19 livers and 9 lungs, corresponding to 2.1 organs/tissues per patient on average. CONCLUSION: This program affords a very important number of organs for transplantation. Further studies are needed to assess the efficacy of mechanical cardiac compressor use in generating more organs.
Assuntos
Serviços Médicos de Emergência/organização & administração , Parada Cardíaca , Transplante de Órgãos/estatística & dados numéricos , Pacientes Ambulatoriais/estatística & dados numéricos , Coleta de Tecidos e Órgãos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Adulto , Reanimação Cardiopulmonar/estatística & dados numéricos , Feminino , Humanos , Masculino , Espanha , Doadores de Tecidos/estatística & dados numéricos , Adulto JovemAssuntos
Fibrinolíticos/administração & dosagem , Fibrinolíticos/uso terapêutico , Hospitalização , Encaminhamento e Consulta , Acidente Vascular Cerebral/tratamento farmacológico , Acidente Vascular Cerebral/terapia , Ativador de Plasminogênio Tecidual/administração & dosagem , Ativador de Plasminogênio Tecidual/uso terapêutico , Feminino , Humanos , MasculinoRESUMO
Eclampsia is an uncommon and serious condition, particularly in the pre-hospital setting. Immediate treatment is required and should include airway control, administration of oxygen, anti-epileptics and magnesium, hypertension control, and urgent delivery of the baby.