Expanding the Donor Pool Through Intensive Care to Facilitate Organ Donation: Results of A Spanish Multicenter Study
BACKGROUNDIntensive Care to facilitate Organ Donation (ICOD) may help to increase the donor pool. We describe the Spanish experience with ICOD. METHODSACCORD-Spain consisted of an audit of the donation pathway from patients dead as a result of a devastating brain injury (possible donors) in 68 hospitals during 11/1/2014-4/30/2015. We focused on possible donors whose family was interviewed to discuss organ donation once intensive care with a therapeutic purpose was deemed futile and brain death (BD) was a likely outcome. RESULTSOf the 1970 possible donors in ACCORD-Spain, in 257 the family was interviewed once the decision had been made not to intubate/ventilate (n=105), with the patient under intubation/ventilation outside of the ICU (n=59), or with the patient intubated/ventilated within the ICU (n=93).Consent to ICOD was obtained in 174 cases. Consent was higher when the donor coordinator participated in the interview [OR 2.32; 95%CI 1.33-4.11; p=0.003]. 131 patients developed BD, of whom 117 transitioned to actual donation after BD. Of the 35 patients who did not develop BD, 2 transitioned to actual donation after circulatory death. 16 patients subject to ICOD were finally medically unsuitable organ donors.ICOD contributed to 24% of the 491 actual donors registered in ACCORD-Spain. CONCLUSIONSDespite the complexity of the interview, the majority of families consent to ICOD. Estimating the probability of BD and assessing medical suitability are additional challenges of the practice. ICOD represents a clear opportunity to increase the donor pool and ensures organ donation is posed at every end-of-life care pathway..
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Artikel |
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| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2017 |
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| Enthalten in: |
Transplantation - (2017) |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Domínguez-Gil, Beatriz [VerfasserIn] |
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| doi: |
10.1097/TP.0000000000001701 |
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| 520 | |a BACKGROUNDIntensive Care to facilitate Organ Donation (ICOD) may help to increase the donor pool. We describe the Spanish experience with ICOD. METHODSACCORD-Spain consisted of an audit of the donation pathway from patients dead as a result of a devastating brain injury (possible donors) in 68 hospitals during 11/1/2014-4/30/2015. We focused on possible donors whose family was interviewed to discuss organ donation once intensive care with a therapeutic purpose was deemed futile and brain death (BD) was a likely outcome. RESULTSOf the 1970 possible donors in ACCORD-Spain, in 257 the family was interviewed once the decision had been made not to intubate/ventilate (n=105), with the patient under intubation/ventilation outside of the ICU (n=59), or with the patient intubated/ventilated within the ICU (n=93).Consent to ICOD was obtained in 174 cases. Consent was higher when the donor coordinator participated in the interview [OR 2.32; 95%CI 1.33-4.11; p=0.003]. 131 patients developed BD, of whom 117 transitioned to actual donation after BD. Of the 35 patients who did not develop BD, 2 transitioned to actual donation after circulatory death. 16 patients subject to ICOD were finally medically unsuitable organ donors.ICOD contributed to 24% of the 491 actual donors registered in ACCORD-Spain. CONCLUSIONSDespite the complexity of the interview, the majority of families consent to ICOD. Estimating the probability of BD and assessing medical suitability are additional challenges of the practice. ICOD represents a clear opportunity to increase the donor pool and ensures organ donation is posed at every end-of-life care pathway. | ||
| 540 | |a Nutzungsrecht: Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved. | ||
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