Non-Heart-Beating Donors From the Streets: An Increasing Donor Pool Source

Crespo, Jorge; Barrio, Roberto; Arias, Jorge-Luis; Ruiz, Francisco; Iglesias, J.; Elias, R. De; Yebenes, C.; Matesanz, J. Matesanz; Caniego, C.

doi:10.1097/00007890-199905150-00068

Cited by 29 publications

(43 citation statements)

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“…[4][5][6][7] After unrecovered cardiac arrest is diagnosed, the donor is transferred to our center. During transportation, advanced cardiopulmonary resuscitation is performed, and it is interrupted at our center for only 5 minutes for the declaration of death according to Spanish law.…”

Section: Octubre University Hospital Protocolmentioning

confidence: 99%

Liver transplantation using uncontrolled non-heart-beating donors under normothermic extracorporeal membrane oxygenation

et al. 2009

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Because of the organ shortage, non-heart-beating donors have been proposed as a possible source of grafts for orthotopic liver transplantation (OLT). Despite the widespread use of controlled non-heart-beating donors, there are only a few published studies reporting the outcomes with uncontrolled non-heart-beating donors (UNHBDs). A prospective case-control study on adult patients undergoing OLT was designed. We used normothermic extracorporeal membrane oxygenation (NECMO) in all UNHBDs. Matching 2:1 ratio comparison was performed between a study group (UNHBDs) and a brain death donor (BDD) control group. Between January 2006 and March 2008, a total of 60 patients were included: 20 in the UNHBD group and 40 in the control group. The incidence of ischemic cholangiopathy was 5% (n ϭ 1) for the UNHBD group and 0% for the BDD group (P ϭ 0.15). The rate of primary nonfunction was 10% (n ϭ 2) in UNHBD recipients and 2.5% (n ϭ 1) in BDD recipients (P ϭ 0.21), with graft loss in all of them. Three patients were retransplanted in the UNHBD group (15%), 2 of them because of primary nonfunction and 1 because of ischemic cholangiopathy; no patient was retransplanted in the control group (P ϭ 0.012). After a mean follow-up of 330.4 Ϯ 224.9 days, 1-year cumulative patient survival was 85.5% for the UNHBD group and 87.5% for the BDD group (P ϭ 0.768). One-year cumulative graft survival was 80% in the UNHBD group and 87.5% in the BDD group (P ϭ 0.774). In conclusion, UNHBDs under NECMO are a potential source of organs for OLT with encouraging outcomes potentially comparable to those obtained with BDDs.

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Section: Octubre University Hospital Protocolmentioning

confidence: 99%

Liver transplantation using uncontrolled non-heart-beating donors under normothermic extracorporeal membrane oxygenation

et al. 2009

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“…Therefore, organs from non heart beating donors (NHBD) can be suitable for transplantation, regardless of a worse first year graft survival outcome 1,2,4,9 . Contemporary aspects of organ donation after cardiac death have stimulated the development of experimental models aiming the improvement of preservation and organ dysfunction 2,6,7 .…”

Section: Introductionmentioning

confidence: 99%

Non heart beating organ donor: new experimental model in pigs

Morais¹,

Júnior²,

Moreno

et al. 2012

Acta Cir. Bras.

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PURPOSE:To describe technical aspects of a new experimental model that simulates a non heart beating organ donor. METHODS:Landrace pigs were operated on and cardiac arrest was obtained by means of myocardial infarction and interruption of ventilator support. RESULTS:Mean cardiac frequency, systolic and diastolic blood pressure levels, central venous pressure, oxygen saturation and concentration of expired CO 2 dropout occurred at seven minutes after cardiac arrest. CONCLUSION:The procedure was easily reproduced and a homogeneous circulatory failure could de obtained by the end of seven minutes. The model is suitable for further studies regarding abdominal organ transplantation.Key words: Transplantation. Models, Animal. Experimental Development. Heart Arrest. Swine. RESUMO OBJETIVO:Descrever os aspectos técnicos de um novo modelo experimental que simula um doador de órgãos após a parada cardíaca. MÉTODOS:Suínos da raça Landrace foram operados e a parada cardíaca foi obtida por meio de infarto do miocárdio e interrupção do suporte ventilatório. RESULTADOS:Freqüência cardíaca, pressão arterial sistólica e diastólica, pressão venosa central, saturação de oxigênio e concentração parcial de CO 2 são consistentes com falência hemodinâmica ao final de sete minutos. CONCLUSÕES:O procedimento foi facilmente executado e uma falência circulatória pode ser obtida ao final de sete minutos. Este modelo é adequado para estudos posteriores com respeito a preservação e tranplantes de órgãos abdominais.

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“…7 In the first 3 years of the protocol, 53 donors were identified, accounting for 42% of the deceased donors in the transplant center. 12 In a more recent 4-year period, the protocol identified 96 donors. 7 Currently, the program retrieves organs from approximately 75 donors a year (A.…”

Section: Experiences With Dcd Involving the Ed And Emsmentioning

confidence: 99%

“…Even in those protocols where death is not declared until the patient arrives in the ED, this is to some extent a formality, as the patient has already failed resuscitation in the field, and the transplant team may already have been notified. 12 Given that the patient is effectively, and possibly legally, dead on arrival at the ED, any involvement the EP has with the case will involve treating a cadaver and preserving organs, not treating a living patient. While it is true that all cases of organ donation reach a stage where physicians are caring for organs and not patients, outside the ED this is done either by physicians who were already caring for the patients before death, and can thus feel that they are continuing the care they began before death, or by physicians who are devoted to the transplant process.…”

Section: Ethical Concerns Regarding Dcds Specific To the Edmentioning

confidence: 99%

“…One solution to this problem, implemented in Spain, is not to have the EPs involved in these cases after death has been declared. 12 Rather, transplant teams take over immediately. This may not be practical, however, in cases where death has been declared in the field and there has not been sufficient notification of the hospital.…”

Section: Ethical Concerns Regarding Dcds Specific To the Edmentioning

confidence: 99%

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