Mateos-Rodríguez Alonso A, Navalpotro-Pascual José Maria, Del Rio Gallegos Francisco, Andrés-Belmonte Amado
Servicio de Urgencia Médica de Madrid, Comisión de Investigación, Spain.
Australas Emerg Nurs J. 2012 Aug;15(3):164-9. doi: 10.1016/j.aenj.2012.05.002. Epub 2012 Jul 24.
The Medical Emergencies Service of Madrid (Spain) (Servicio de Urgencias Medicas de Madrid), SUMMA112, forms part of an organ donor program involving patients who have suffered out-hospital cardiac arrest and fail to respond to advanced cardiopulmonary resuscitation maneuvers. Subjects meeting the inclusion criteria are moved to a transplant unit under sustained resuscitation maneuvering in order to harvest the organs. This paper presents compliance with the timelines of the program, the proportion of donors, the characteristics of donors and non-donors, and the number of organs obtained.
A retrospective descriptive study was made based on the review of case histories. The SPSS(©) version 16.0 statistical package was used for data analysis.
A total of 214 cases were recorded, of which 84% were males. The mean age was 40 years. The mean time to arrival on scene was 13 min and 34 s. The mean time to arrival in hospital was 88 min and 10 s. A total of 522 organs and tissues were harvested (250 kidneys, 33 livers, 123 corneas, 97 bone tissues and 19 lungs), corresponding to 3.2 organs/tissues per patient on average. A total of 21.7% of the patients were not valid. There were no differences between the valid and non-valid patients in terms of age and gender. The causes of non-donation included extracorporeal circuit failure (6.3%), family refusal (15.6%), patient refusal expressed in life (4.7%), legal denial (1.6%), biological causes (51.6%), and others (20.3%). Cardiac compressors were used in 85 cases, yielding 92 kidneys, 41 corneas, 30 bone tissues, 19 livers and 9 lungs, corresponding to 2.1 organs/tissues per patient on average.
This program affords a very important number of organs for transplantation. Further studies are needed to assess the efficacy of mechanical cardiac compressor use in generating more organs.
西班牙马德里的医疗急救服务机构SUMMA112是器官捐献项目的一部分，该项目涉及院外心脏骤停且对高级心肺复苏操作无反应的患者。符合纳入标准的受试者在持续复苏操作下被转移至移植单元，以便获取器官。本文介绍了该项目的时间线合规情况、捐献者比例、捐献者和非捐献者的特征以及获取的器官数量。
基于病历回顾进行了一项回顾性描述性研究。使用SPSS(©) 16.0版统计软件包进行数据分析。
共记录214例病例，其中84%为男性。平均年龄为40岁。平均到达现场时间为13分34秒。平均到达医院时间为88分10秒。共获取522个器官和组织（250个肾脏、33个肝脏、123个角膜、97个骨组织和19个肺），平均每位患者对应3.2个器官/组织。共有21.7%的患者不符合要求。在年龄和性别方面，符合要求和不符合要求的患者之间没有差异。非捐献原因包括体外循环失败（6.3%）、家属拒绝（15.6%）、生前患者拒绝（4.7%）、法律拒绝（1.6%）、生物学原因（51.6%）和其他原因（20.3%）。85例使用了心脏按压设备，获取了92个肾脏、41个角膜、30个骨组织、19个肝脏和9个肺，平均每位患者对应2.1个器官/组织。
该项目为移植提供了数量可观的器官。需要进一步研究以评估使用机械心脏按压设备获取更多器官的效果。
