Medicina Intensiva  (English Edition) Medicina Intensiva  (English Edition)
Med Intensiva 2017;41:153-61 - Vol. 41 Num.3 DOI: 10.1016/j.medine.2017.03.006
Original
Estimation of potential donors after cardiocirculatory death in Elche University General Hospital (Alicante, Spain)
Estimación de potenciales donantes en muerte cardiocirculatoria en el Hospital General Universitario de Elche
E. Tenzaa,, , R. Valerob, V. Arraeza
a Hospital General Universitario de Elche, Alicante, Spain
b Hospital Clínic de Barcelona, Barcelona, Spain
Received 17 March 2016, Accepted 25 August 2016
Abstract
Objective

To evaluate the number and characteristics of potential organ donors among cardiocirculatory death cases.

Design and setting

A retrospective observational study was made of individuals between 15 and 65 years of age who died in the period 2006–2014 in Elche University General Hospital (Alicante, Spain).

Intervention

A univariate analysis and binary logistic regression predictive model were performed to discriminate factors related to donation contraindication.

Variables of interest

Identification of patients with donation contraindication.

Results

Of the 1510 patients who died in the mentioned period, 1048 were excluded due to the application of exclusion criteria; 86 due to evolution toward brain death; and 20 due to losses. A total of 356 patients were analyzed, divided into two groups: 288 in non-heart beating donation II and 68 in non-heart beating donation III. Seventy patients were found to be potential non-heart beating donation II and 10 were found to be potential non-heart beating donation III, which could increase donation activity by 8–9 donors a year. The patients died in the ICU, Resuscitation, Emergency Care, Internal Medicine, Digestive Diseases and Neurology. The following protective factors against organ donation contraindication were identified: death in Emergency Care, cardiorespiratory arrest before or during admission, and heart, respiratory and neurological disease as the cause of admission. Death in Internal Medicine was associated to an increased risk of donation contraindication.

Conclusions

Implementing a non-heart beating donation protocol in our hospital could increase the donation potential by 8–9 donors a year.

Resumen
Objetivo

Estimar el número y las características de potenciales donantes de órganos de personas fallecidas por muerte cardiocirculatoria.

Diseño y ámbito

Estudio retrospectivo observacional de los fallecidos entre 15-65 años entre el 2006 y 2014 en el Hospital General Universitario de Elche.

Intervención

Realización de análisis univariante y modelo predictivo de regresión logística binaria para discriminar los factores relacionados con la contraindicación para la donación.

Variables de interés

Identificar los pacientes con contraindicaciones para la donación.

Resultados

De los 1.510 pacientes fallecidos se excluyeron 1.048 por criterios crónicos de exclusión, 86 por evolucionar a muerte encefálica y 20 por pérdidas. Se analizaron 356 pacientes en 2 grupos: 288 en donación en asistolia ii y 68 en donación en asistolia iii. Resultaron potenciales donantes en asistolia ii 70 pacientes y 10 donantes en asistolia iii, lo que podría incrementar la actividad de donación en 8-9 donantes/año. Los pacientes fallecieron en: UCI, reanimación, urgencias, medicina interna, digestivo y neurología. Resultaron variables protectoras frente a contraindicación para la donación: fallecer en urgencias, parada cardiorrespiratoria previa o durante el ingreso, la enfermedad cardiológica, respiratoria y neurológica como causa de ingreso. Fallecer en el servicio de medicina interna se asoció a un mayor riesgo de contraindicaciones para la donación.

Conclusiones

Poner en marcha un protocolo de donación en asistolia en nuestro hospital podría incrementar el potencial de donación en unos 8-9 donantes/año.

Keywords
Cardiocirculatory donors, Potential donors, Limitation of life-sustaining treatments, Cardiocirculatory death
Palabras clave
Donación en asistolia, Potenciales donantes, Limitación de tratamientos de soporte vital, Muerte cardiocirculatoria

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Med Intensiva 2017;41:153-61 - Vol. 41 Num.3 DOI: 10.1016/j.medine.2017.03.006