Westphal G A, Caldeira Filho M, Fiorelli A, Vieira K D, Zaclikevis V, Bartz M, Wanzuita R, Teixeira C, Franke C, Machado F O, Friedman G, Andrade J, Matos J D, Lamgaro D M, Silva E, Costa G, Coelho M E, Oliveira M C, Youssef N C M, Akamine N, Duarte P, Lisboa R, Mazzali M, Ferraz Neto B H
Brazilian Association of Intensive Medicine, the Brazilian Association of Organ Transplants (ABTO), and the Transplantation Center of Santa Catarina (SC-Tx), Santa Catarina, Brazil.
Transplant Proc. 2012 Oct;44(8):2260-7. doi: 10.1016/j.transproceed.2012.07.019.
The organ shortage for transplantation, the principal factor that increases waiting lists, has become a serious public health problem. In this scenario, the intensivist occupies a prominent position as one of the professionals that first has a chance to identify brain death and to be responsible for the maintenance of the potential deceased donor.
This report attempts to establish guidelines for care and maintenance of adult deceased donor organs guiding and standardizing care provided to patients with brain death.
These guidelines were composed by intensivists, transplant coordinators, professionals from various transplant teams, and used transplant center. The formulated questions were forwarded to all members and recommendations were constructed after an extensive literature review selecting articles with the highest degree of evidence.
Guidelines were developed in the form of questions reflecting frequent experiences in clinical intensive care practices. The main questions were: Is there an optimal interval for keeping organs of deceased donors viable? What actions are considered essential for maintaining deceased donors in this period? What are the limits of body temperature? How should the patient be warmed? Which laboratory tests should be performed? What is the collection interval? What are the limits in the laboratory and the capture scenario? What are the limits of blood pressure? When and how should one use catecholamines?
This pioneer project involved a multidisciplinary team working in organ transplantation seeking to provide treatment guidance to increase the number of viable organs from deceased adult donors.
器官移植供体短缺是导致等待名单增加的主要因素，已成为一个严重的公共卫生问题。在这种情况下，重症监护医生作为最早有机会识别脑死亡并负责维持潜在已故供体的专业人员之一，占据着重要地位。
本报告试图制定成人已故供体器官护理和维护指南，以指导和规范为脑死亡患者提供的护理。
这些指南由重症监护医生、移植协调员、各移植团队的专业人员以及使用过的移植中心共同制定。将拟定的问题分发给所有成员，并在广泛的文献综述后构建建议，所选文章具有最高程度的证据。
指南以反映临床重症监护实践中常见经验的问题形式制定。主要问题包括：已故供体器官保持存活的最佳间隔时间是多久？在此期间，哪些行动被认为对维持已故供体至关重要？体温的限度是多少？应如何为患者升温？应进行哪些实验室检查？采集间隔是多久？实验室和采集场景中的限度是什么？血压的限度是多少？何时以及如何使用儿茶酚胺？
这个开创性项目涉及一个从事器官移植的多学科团队，旨在提供治疗指导，以增加来自已故成人供体的存活器官数量。
