Eduardo Miñambres1, Jose Miguel Pérez-Villares2, Luis Terceros-Almanza3, Jose María Dueñas-Jurado4, Arturo Zabalegui5, Maite Misis6, Maria Teresa Bouza7, María Angeles Ballesteros8, Elisabeth Coll9. 1. Service of Intensive Care, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain eminambres@yahoo.es. 2. Service of Intensive Care, University Hospital Virgen de las Nieves, Granada, Spain. 3. Service of Intensive Care, University Hospital Doce de Octubre, Madrid, Spain. 4. Service of Intensive Care, University Hospital Reina Sofía, Cordoba, Spain. 5. Service of Intensive Care, University Hospital General de Burgos, Burgos, Spain. 6. Service of Intensive Care, University Hospital Germans Trias i Pujol, Badalona, Spain. 7. Transplant Coordination Unit, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain. 8. Service of Intensive Care, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain. 9. Organización Nacional de Trasplantes (ONT), Madrid, Spain.
Abstract
OBJECTIVES: Competing requirements for organ perfusion may call for antagonistic strategies such as fluid replacement or high positive end-expiratory pressure. We recently proposed an intensive lung donor treatment protocol that nearly tripled lung procurement rates and validated it in a multicentre study. The next step was to evaluate the impact of our proposal on the other organ grafts recovered from lung donors and on the recipients' outcome after transplantation of those grafts. METHODS: A quasi-experimental study was conducted in six Spanish hospitals during 2013 (2010-12 was historical control). Organ donor management was led by a trained and experienced intensive care staff. RESULTS: A total of 618 actual donors after brain death (DBDs) were included, 453 DBDs in the control period (annual average 151) and 165 in the protocol period. No baseline differences were found between the periods. Heart, liver, kidney and pancreas retrieval rates were similar in both periods, and heart, liver, kidney and pancreas recipients' survival at 3 months showed no differences between both periods. CONCLUSIONS: Our lung donor treatment protocol is safe for other grafts obtained from donors undergoing these procedures with the aim of increasing lungs available for transplantation. It has no negative impact on the recovery rates of other grafts or on early survival of heart, liver, pancreas or kidney recipients.
OBJECTIVES: Competing requirements for organ perfusion may call for antagonistic strategies such as fluid replacement or high positive end-expiratory pressure. We recently proposed an intensive lung donor treatment protocol that nearly tripled lung procurement rates and validated it in a multicentre study. The next step was to evaluate the impact of our proposal on the other organ grafts recovered from lung donors and on the recipients' outcome after transplantation of those grafts. METHODS: A quasi-experimental study was conducted in six Spanish hospitals during 2013 (2010-12 was historical control). Organ donor management was led by a trained and experienced intensive care staff. RESULTS: A total of 618 actual donors after brain death (DBDs) were included, 453 DBDs in the control period (annual average 151) and 165 in the protocol period. No baseline differences were found between the periods. Heart, liver, kidney and pancreas retrieval rates were similar in both periods, and heart, liver, kidney and pancreas recipients' survival at 3 months showed no differences between both periods. CONCLUSIONS: Our lung donor treatment protocol is safe for other grafts obtained from donors undergoing these procedures with the aim of increasing lungs available for transplantation. It has no negative impact on the recovery rates of other grafts or on early survival of heart, liver, pancreas or kidney recipients.
Authors: Vanesa Romina Ruiz; Sergio Adrián Terrasa; Susana Bauque; Pablo Ezequiel Rodriguez; Verónica Celia Morozovsky; Alejandro Gabriel Da Lozzo; Alejandro Daniel Midley Journal: Rev Bras Ter Intensiva Date: 2022-01-24