da Silva Bento Pamela, Santiago Alessandra Duarte, Vendrame Saes Letícia Sandre, Erbs Pessoa João Luís, Ockner Silva Thalyta Larissa, Schirmer Janine, de Aguiar Roza Bartira
Paulista Nursing School, Federal University of São Paulo, São Paulo, Brazil.
Intra-Hospital Commission of Organ and Tissue Donation for Transplant, Hospital São Paulo, São Paulo, Brazil.
Transplant Proc. 2020 Jun;52(5):1226-1230. doi: 10.1016/j.transproceed.2020.02.020. Epub 2020 Mar 17.
Statistics indicate low utilization of potential donors, where only about one-third are converted into actual donors. In this context, it is plausible to argue that many potential donors are not hemodynamically stable for harvesting multiple organs since the procedures for maintaining parameters of stability may not be a priority in all critical care units in the country. Thus, it is necessary to identify losses of potential donors due to hemodynamic maintenance since reversing this situation enable minimizing mortality on waiting lists.
This was a retrospective quantitative study, based on information sent to Notification, Organ Procurement, and Distribution Centers by reporting hospitals in the state of São Paulo, using the Death Information Form regarding the specifics of each death registered in their intensive care units and emergency rooms.
Hemodynamic instability contributed to a loss of 537 potential donors, corresponding to 61.9% of failures to obtain potentially transplantable organs.
Of the 33,175 cases of death reported, 867 fulfilled the criteria to be possible and potential donors (ie, patients diagnosed with brain death). Among these cases, 38.1% fulfilled Criterion 3 (ie, they were hemodynamically stable and in ideal organ donation condition). Therefore, this study concludes that losses due to maintenance occurred in 537 brain dead patients. This finding highlights the importance of investing in the development of competencies of professionals who work in critical care units to increase the number of multiple organ and tissue donors and reduce waiting lists.
统计数据表明潜在供体的利用率较低,只有约三分之一的潜在供体转化为实际供体。在这种情况下,可以合理地认为,许多潜在供体在进行多器官采集时血流动力学不稳定,因为维持稳定性参数的程序在该国所有重症监护病房中可能并非优先事项。因此,有必要确定因血流动力学维持导致的潜在供体损失,因为扭转这种情况能够最大限度地减少等待名单上的死亡率。
这是一项回顾性定量研究,基于圣保罗州报告医院发送给通知、器官采购和分配中心的信息,使用关于在其重症监护病房和急诊室登记的每例死亡详情的死亡信息表。
血流动力学不稳定导致537名潜在供体流失,占未能获得潜在可移植器官情况的61.9%。
在报告的33175例死亡病例中,867例符合可能和潜在供体的标准(即被诊断为脑死亡的患者)。在这些病例中,38.1%符合标准3(即他们血流动力学稳定且处于理想的器官捐赠状态)。因此,本研究得出结论,537例脑死亡患者因维持治疗而出现损失。这一发现凸显了投资培养重症监护病房专业人员能力的重要性,以增加多器官和组织供体数量并减少等待名单。