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Assessing Outcomes of Patients Subject to Intensive Care to Facilitate Organ Donation: A Spanish Multicenter Prospective Study.
Pérez-Blanco, Alicia; Acevedo, María; Padilla, María; Gómez, Aroa; Zapata, Luis; Barber, María; Martínez, Adolfo; Calleja, Verónica; Rivero, María C; Fernández, Esperanza; Velasco, Julio; Flores, Eva M; Quindós, Brígida; Rodríguez, Sergio T; Virgós, Beatriz; Robles, Juan C; Nebra, Agustín C; Moya, José; Trenado, Josep; García, Nieves; Vallejo, Ana; Herrero, Eugenio; García, Álvaro; Rodríguez, Maria L; García, Fernando; Lara, Ramón; Lage, Lucas; Gil, Francisco J; Guerrero, Francisco J; Meilán, Ángela; Del Prado, Nayade; Fernández, Cristina; Coll, Elisabeth; Domínguez-Gil, Beatriz.
Afiliación
  • Pérez-Blanco A; Organización Nacional de Trasplantes, Madrid, Spain.
  • Acevedo M; Hospital Universitario Puerta de Hierro, Madrid, Spain.
  • Padilla M; Organización Nacional de Trasplantes, Madrid, Spain.
  • Gómez A; Hospital Universitario Vall d'Hebrón, Barcelona, Spain.
  • Zapata L; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
  • Barber M; Hospital Universitario de Navarra, Pamplona, Spain.
  • Martínez A; Hospital Universitario Ramón y Cajal, Madrid, Spain.
  • Calleja V; Hospital de San Pedro, Logroño, Spain.
  • Rivero MC; Complejo Hospitalario Universitario, Santiago de Compostela, Spain.
  • Fernández E; Hospital Universitario Virgen del Rocio, Sevilla, Spain.
  • Velasco J; Hospital Universitario Son Espases, Palma de Mallorca, Spain.
  • Flores EM; Hospital Universitario La Paz, Madrid, Spain.
  • Quindós B; Hospital Universitario Central de Asturias, Oviedo, Spain.
  • Rodríguez ST; Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain.
  • Virgós B; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
  • Robles JC; Hospital Universitario Reina Sofía, Córdoba, Spain.
  • Nebra AC; Hospital Universitario Miguel Servet, Zaragoza, Spain.
  • Moya J; Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
  • Trenado J; Hospital Universitario Mútua Terrasa, Barcelona, Spain.
  • García N; Hospital Universitario La Princesa, Madrid, Spain.
  • Vallejo A; Hospital Universitario de Araba, Vitoria-Gasteiz, Spain.
  • Herrero E; Hospital Universitario de Torrevieja, Alicante, Spain.
  • García Á; Complejo Asistencial Universitario, Salamanca, Spain.
  • Rodríguez ML; Complejo Hospitalario Universitario, Toledo, Spain.
  • García F; Complejo Hospitalario Universitario, Albacete, Spain.
  • Lara R; Hospital Universitario Virgen de las Nieves, Granada, Spain.
  • Lage L; Hospital Álvaro Cunqueiro, Vigo, Spain.
  • Gil FJ; Hospital General Universitario Santa Lucía, Cartagena, Spain.
  • Guerrero FJ; Hospital Universitario de Torrecárdenas, Almería, Spain.
  • Meilán Á; Hospital Universitario Central de Asturias, Oviedo, Spain.
  • Del Prado N; Fundación IMAS, Madrid, Spain.
  • Fernández C; Hospital Clínico Universitario de Santiago, Instituto de Investigaciones Sanitarias de Santiago, Santiago, Spain.
  • Coll E; Organización Nacional de Trasplantes, Madrid, Spain.
  • Domínguez-Gil B; Organización Nacional de Trasplantes, Madrid, Spain.
Transpl Int ; 37: 12791, 2024.
Article en En | MEDLINE | ID: mdl-38681973
ABSTRACT
Intensive Care to facilitate Organ Donation (ICOD) consists of the initiation or continuation of intensive care measures in patients with a devastating brain injury (DBI) in whom curative treatment is deemed futile and death by neurological criteria (DNC) is foreseen, to incorporate organ donation into their end-of-life plans. In this study we evaluate the outcomes of patients subject to ICOD and identify radiological and clinical factors associated with progression to DNC. In this first prospective multicenter study we tested by multivariate regression the association of clinical and radiological severity features with progression to DNC. Of the 194 patients, 144 (74.2%) patients fulfilled DNC after a median of 25 h (95% IQR 17-44) from ICOD onset. Two patients (1%) shifted from ICOD to curative treatment, both were alive at discharge. Factors associated with progression to DNC included age below 70 years, clinical score consistent with severe brain injury, instability, intracranial hemorrhage, midline shift ≥5 mm and certain types of brain herniation. Overall 151 (77.8%) patients progressed to organ donation. Based on these results, we conclude that ICOD is a beneficial and efficient practice that can contribute to the pool of deceased donors.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Obtención de Tejidos y Órganos / Cuidados Críticos Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Transpl Int Asunto de la revista: TRANSPLANTE Año: 2024 Tipo del documento: Article País de afiliación: España

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Obtención de Tejidos y Órganos / Cuidados Críticos Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Transpl Int Asunto de la revista: TRANSPLANTE Año: 2024 Tipo del documento: Article País de afiliación: España