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2024, Number 2

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Rev Mex Traspl 2024; 13 (2)

Assessment in the management of potential cadaveric donor patients over 10 years at Centenario Hospital Miguel Hidalgo

García-Lomelí A, Castillo-González RA, Rodríguez-García AD

Language: Spanish
References: 29
Page: 64-76
PDF size: 332.28 Kb.


ABSTRACT

Introduction: the diagnosis and certification of death historically relied on the observation of the irreversible cessation of cardiovascular and respiratory functions. In the latter half of the 20th century, the use of life support through assisted mechanical ventilation and hemodynamic support within critical care units allowed for the maintenance of cardiovascular activity in individuals with severe brain injuries, who exhibited absence of brain functions. The diagnosis of brain death is a medical responsibility, especially within intensive care units, carrying significant medical, legal, and ethical implications that demand reflection based on the dignity of the individual in question. The Centenario Hospital Miguel Hidalgo, under the jurisdiction of the Ministry of Health and integrated into the State Health System, initiated its renal transplant program in November 1990, conducting a total of 1,050 kidney transplants from November 6 1990, to June 30 2011. Material and methods: a total of 63 patient files registered in the CENATRA platform (National Transplant Center) between September 2011 and January 2020, who were candidates for multi-organ procurement at the Centenario Hospital Miguel Hidalgo, were analyzed. The list of patient files registered in the platform was obtained, and they were requested from the archive area of the Centenario Hospital Miguel Hidalgo. Each mentioned file was physically obtained and evaluated for patient management according to national and international guidelines. Management goals established in each admission note from the emergency department of the Centenario Hospital Miguel Hidalgo to the death certificate, where the causes of death were stipulated, were considered. The analysis was conducted to determine if variable ranges were maintained within goals for procurement optimization. A statistical average of total values was calculated, representing how many met the requirements of current management and how many did not, comparing these results with those obtained in national and international guidelines. Results: a comprehensive review of a total of 63 files of cadaveric donor patients from September 2011 to January 2020 was conducted. Fifty-five patients were considered for management analysis. Among the age ranges, 18 to 70 years old were found. On average, the number of organs procured registered in the CENATRA platform was 4.05, with traumatic brain injury being the leading cause of brain death in potential donors. Regarding gender, there were 38 male and 17 female donors, representing 69 and 31%, respectively. Conclusions: promotion of health programs aimed at promoting and disseminating donation is essential for enriching programs like those carried out by CENATRA and for providing greater life opportunities to patients on organ and tissue waiting lists. Similarly, raising awareness in society about the importance of both living and cadaveric donation, as well as addressing any doubts about this noble process, is crucial.


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