Complications during the maintenance of real-organ donors in brain death
Keywords:
Brain death, Maintenance, Tissue and organ procurement.Abstract
Introduction: proper handling of potential donors before and after the diagnosis of brain death can improve the number and quality of the organs procured.
Objective: to learn about the complications of keeping real-organ donors in brain death at Abel Santamaria Cuadrado General Teaching Hospital during the years 2014 and 2015.
Material and Methods: a descriptive, cross-sectional prospective study in patients with the diagnosis of brain death who were admitted to the intensive care unit. Data were collected from the medical records; the target group included 36 patients with brain death and the sample was comprised of 15 real-donor patients.
Results: there was a predominance of male sex (66.67%), with the highest number of cases between 31 and 50 years of age. Hemorrhagic cerebrovascular disease was the cause that most contributed to the diagnosis of brain death with 73.33%, hypotension was present in all cases, hypernatremia and diabetes insipidus appeared in 73.33%, followed by hypokalemia (66.67%) and hypothermia (60%); extraction of organs was performed within the 4 - 8 hours after brain-death diagnosis in the 80% of real-donors.
Conclusions: awareness of the complications arising during the maintenance of real-organ donors is of vital importance, since it may adversely affect the viability of the organ to be transplanted; early identification and appropriate treatment must be improved in order to achieve the crucial goal, transplantation.
Downloads
References
1.McKeown DW, Bonser RS, Kellum JA. Management of the heartbeating brain-dead organ donor. Br J Anaesth [Internet]. 2012 [citado 10 Nov 2015]; 108(Suppl-1): 96-107. Disponible en: http://bja.oxfordjournals.org/content/108/suppl_1/i96.full.
2. Querevalú Murillo W, Orozco Guzmán R, Díaz Tostado S. Mantenimiento del donante cadavérico en la Unidad de Terapia Intensiva. Revista de la asociación mexicana de medicina crítica y terapia intensiva [Internet]. 2013 Abr-Jun [citado 10 Nov 2015]; 27(2): 107-14. Disponible en: http://www.medigraphic.com/pdfs/medcri/ti-2013/ti132g.pdf
3. Dueñas Jurado JM. Protocolos clínicos de actuación ante el proceso de donación y extracción de órganos y tejidos para trasplante en donación en muerte encefálica. Cuad Med Forense [Internet]. 2015 Ene-Jun [citado 10 Nov 2015]; 21(1-2): 34-42. Disponible en: http://scielo.isciii.es/scielo.php?pid=S1135-76062015000100005&script=sci_arttext&tlng=en.
4.Bodí MA, Pont T, Sandiumenge A, Oliver E, Gener J, Badía M, et al. Potencialidad de donación de órganos en muerte encefálica y limitación del tratamiento de soporte vital en los pacientes neurocríticos. Med Intensiva [Internet]. 2015 [citado 10 Nov 2015]; 39(6): 337-44. Disponible en: http://linkinghub.elsevier.com/retrieve/pii/S0210569114002095?via=sd
5. Freire SG, Freire Silvério IL, Pinto Jales Menescal JT, Vasconcelos Quinidia de Lúcia Duarte de AQ, Torres De Vasconcelos G. Alterações fisiológicas da morte encefálica em potenciais doadores de órgãos e tecidos para transplanten. Esc Anna Nery Rev Enferm [Internet]. 2012 Out-Dez [citado 23 Jul 2015]; 16(4):. Disponible en: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1414-81452012000400017.
6. Fortuna Custodio JA, Rivera Marchena JR, Jiménez Lomas S, Morales Flores ME, Roldán García AM, Navarro Paz I, et al. Donación de órganos: metas del mantenimiento en el paciente con muerte encefálica. Revista de la Asociación Mexicana de Medicina Crítica y Terapia Intensiva [Internet]. 2014 Oct-Dic [citado 10 Nov 2015]; 28(4): 221-38. Disponible en: http://www.google.com.cu/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwikzdPZ-PnKAhXrmIMKHT_0CuAQFggfMAA&url=http%3A%2F%2Fnew.medigraphic.com%2Fcgi-bin%2Fresumen.cgi%3FIDARTICULO%3D52825&usg=AFQjCNElPyEMhh97HPGA_3nBE-UvO18Dcw&bvm=bv.114195076,d.amc
7. Escudero D, Valentín MO, Escalante JL, Sanmartín A, Perez-Basterrechea M, de Gea J, et al. Intensive care practices in brain death diagnosis and organ donation. Anaesthesia [Internet]. 2015 [citado 10 Nov 2015]; 70(10). Disponible en: http://onlinelibrary.wiley.com/doi/10.1111/anae.13065/full
8. Simas R, Kogiso Haruo D, Correia de Jesus C, Silva Ferraz da LF, Silva Azevedo I, Cruz Miranda Costa JW, et al. Influence of brain death and associated trauma on solid organ histological characteristicas. Acta Cir Bras [Internet]. 2012 Jul [citado 23 Jul 2015]; 27(7): [aprox. 9 p.]. Disponible en: http://www.scielo.br/scielo.php?pid=S0102-86502012000700006&script=sci_arttext
9. Sociedad argentina de terapia intensiva SATI. Terapia Intensiva. 5ta Ed. España: Editorial Médica Panamericana; 2015.

Published
How to Cite
Issue
Section
License
Authors who have publications with this journal agree to the following terms: Authors will retain their copyrights and grant the journal the right of first publication of their work, which will be publication of their work, which will be simultaneously subject to the Creative Commons Attribution License (CC-BY-NC 4.0) that allows third parties to share the work as long as its author and first publication in this journal are indicated.
Authors may adopt other non-exclusive license agreements for distribution of the published version of the work (e.g.: deposit it in an institutional telematic archive or publish it in a volume). Likewise, and according to the recommendations of the Medical Sciences Editorial (ECIMED), authors must declare in each article their contribution according to the CRediT taxonomy (contributor roles). This taxonomy includes 14 roles, which can be used to represent the tasks typically performed by contributors in scientific academic production. It should be consulted in monograph) whenever initial publication in this journal is indicated. Authors are allowed and encouraged to disseminate their work through the Internet (e.g., in institutional telematic archives or on their web page) before and during the submission process, which may produce interesting exchanges and increase citations of the published work. (See The effect of open access). https://casrai.org/credit/