Assessing Outcomes of Patients Subject to Intensive Care to Facilitate Organ Donation: A Spanish Multicenter Prospective Study
Por:
Perez-Blanco, A, Acevedo, M, Padilla, M, Gomez, A, Zapata, L, Barber, M, Martinez, A, Calleja, V, Rivero, MC, Fernandez, E, Velasco, J, Flores, EM, Quindos, B, Rodriguez, ST, Virgos, B, Nebra, AC, Robles, JC, Moya, J, Trenado, J, Garcia, N, Vallejo, A, Herrero, E, Garcia, A, Rodriguez, ML, Garcia, F, Lara, R, Lage, L, Gil, FJ, Guerrero, FJ, Meilan, A, Del Prado, N, Fernandez, C, Coll, E, Dominguez-Gil, B
Publicada:
12 abr 2024
Resumen:
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.
Filiaciones:
Perez-Blanco, A:
Org Nacl Trasplantes, Madrid, Spain
Acevedo, M:
Hosp Univ Puerta Hierro, Madrid, Spain
Padilla, M:
Org Nacl Trasplantes, Madrid, Spain
Gomez, A:
Hosp Univ Vall dHebron, Barcelona, Spain
Zapata, L:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Barber, M:
Hosp Univ Navarra, Pamplona, Spain
Martinez, A:
Hosp Univ Ramon & Cajal, Madrid, Spain
Calleja, V:
Hosp San Pedro, Logrono, Spain
Rivero, MC:
Complejo Hosp Univ, Santiago De Compostela, Spain
Fernandez, E:
Hosp Univ Virgen Rocio, Seville, Spain
Velasco, J:
Hosp Univ Son Espases, Palma De Mallorca, Spain
Flores, EM:
Hosp Univ La Paz, Madrid, Spain
Quindos, B:
Hosp Univ Cent Asturias, Oviedo, Spain
Rodriguez, ST:
Hosp Univ Nuestra Senora Candelaria, Santa Cruz De Tenerife, Spain
Virgos, B:
Hosp Clin Univ Lozano Blesa, Zaragoza, Spain
Nebra, AC:
Hosp Univ Miguel Servet, Zaragoza, Spain
Robles, JC:
Hosp Univ Reina Sofia, Cordoba, Spain
Moya, J:
Hosp Univ Virgen Arrixaca, Murcia, Spain
Trenado, J:
Hosp Univ Mutua Terrasa, Barcelona, Spain
Garcia, N:
Hosp Univ Princesa, Madrid, Spain
Vallejo, A:
Hosp Univ Araba, Vitoria, Spain
Herrero, E:
Hosp Univ Torrevieja, Alicante, Spain
Garcia, A:
Complejo Asistencial Univ Salamanca, Salamanca, Spain
Rodriguez, ML:
Complejo Hosp Univ Toledo, Toledo, Spain
Garcia, F:
Complejo Hosp Univ, Albacete, Spain
Lara, R:
Hosp Univ Virgen Nieves, Granada, Spain
Lage, L:
Hosp Alvaro Cunqueiro, Vigo, Spain
Gil, FJ:
Hosp Gen Univ St Lucia, Cartagena, Spain
Guerrero, FJ:
Hosp Univ Torrecardenas, Almeria, Spain
Meilan, A:
Hosp Univ Cent Asturias, Oviedo, Spain
Del Prado, N:
Fdn IMAS, Madrid, Spain
Fernandez, C:
Hosp Clin Univ Santiago, Inst Invest Sanit Santiago, Santiago, Spain
Coll, E:
Org Nacl Trasplantes, Madrid, Spain
Dominguez-Gil, B:
Org Nacl Trasplantes, Madrid, Spain
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