Fernández Elena, Calatayud Joaquín, Jarabo José Ramón, Hernando Florentino, Rodríguez Olga, Gómez Ana María, Soria Ana, Del Río Francisco
Hospital Clinico San Carlos, Madrid, Spain.
Eur J Cardiothorac Surg. 2009 Feb;35(2):287-91; discussion 291-2. doi: 10.1016/j.ejcts.2008.10.030. Epub 2008 Dec 11.
In 2002 the first lung transplant from non heart beating (NHB) donors took place in Madrid. The objective of this study was to analyse our Maastricht type I NHB lung donors retrieval program and to check out its profitability.
Based on the NHB lung donors retrieval program carried out at Hospital Clínico San Carlos (Madrid) in association with Hospital Puerta de Hierro (Madrid), all lung donors from the beginning of the program from June 2002 to December 2006 have been analysed. When faced with a case of sudden death, advanced life support manoeuvres are initiated before 15 min. If the patient meets a given set of criteria, code 0/9 is activated. Arrival time to the hospital cannot exceed 90 min. Femoral artery and vein are cannulated, extracorporeal circulation is started and lungs are preserved. After the relatives' and judicial authorisation lungs are retrieved.
Out of a total of 322 occurrences of code 0/9, 43 lung retrievals and 25 implants were reported. A total of 95% of donors were male, with an average age of 41 years and 91% with blood group A or O. 2004 saw the highest number of retrievals (14). January, May and December showed the highest number of retrievals. Incidence of sudden deaths was higher from 7 to 10 a.m. and from 7 to 10 p.m. Twenty-three implants at Hospital Puerta de Hierro and three more at Hospital Marqués de Valdecilla (Santander) were reported. A considerable amount of preserved lungs, valid for transplant, were not retrieved because of a lack of an appropriate recipient at the time.
A total of 58.1% of preserved lungs were implanted. The ratio of obtained lungs was 11.4% of actual donors and 7.7% of total occurrences. However, this percentage could have been higher if we take into account the number of valid lungs that were not transplanted because of the lack of recipients.
2002年在马德里进行了首例非心脏跳动（NHB）供体的肺移植手术。本研究的目的是分析我们的马斯特里赫特I型NHB肺供体获取计划，并检查其效益。
基于在马德里圣卡洛斯临床医院与马德里铁之门医院联合开展的NHB肺供体获取计划，对2002年6月至2006年12月该计划启动以来的所有肺供体进行了分析。遇到猝死病例时，在15分钟内启动高级生命支持措施。如果患者符合一组特定标准，激活0/9代码。到达医院的时间不能超过90分钟。对股动脉和静脉进行插管，开始体外循环并保存肺脏。在获得亲属和司法授权后摘取肺脏。
在总共322次0/9代码事件中，报告了43次肺脏摘取和25次植入。供体中95%为男性，平均年龄4l岁，91%为A或O血型。2004年摘取数量最多（14次）。1月、5月和12月摘取数量最多。猝死发生率在上午7点至10点以及晚上7点至10点较高。报告了铁之门医院的23次植入以及桑坦德瓦尔迪西利亚侯爵医院的另外3次植入。由于当时缺乏合适的受者，大量可用于移植的保存肺脏未被摘取。
总共58.1%的保存肺脏被植入。获得的肺脏比例为实际供体的11.4%，总事件的7.7%。然而，如果考虑到因缺乏受者而未移植的有效肺脏数量，这个百分比可能会更高。
