Assessing Outcomes of Patients Subject to Intensive Care to Facilitate Organ Donation: A Spanish Multicenter Prospective Study

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 i...

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Detalles Bibliográficos
Autores: 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
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p17663
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=17663
http://ddd.uab.cat/record/306309
Access Level:acceso abierto
Palabra clave:transplantation
deceased organ donation
death by neurologic criteria
devastating brain injury
intensive care to facilitate organ donation
Descripción
Sumario: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.

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