Bahena-Carrera L, Erro-Aboytia R, Sánchez-Cedillo IA, López-Falcony R, Noyola-Villalobos HF, Guzmán-Cárdenas DO, Muñoz-Arce CM, Aburto-Morales JS

Language: Spanish
References: 24
Page: 34-41
PDF size: 337.01 Kb.

ABSTRACT

Introduction: at the national level there is a significant gap between supply and demand in terms of kidney and liver transplantation; it is the most appropriate health policy to perform the majority of these transplants with cadaveric donors. In Mexico there is no formal organ transplant program with donors after circulatory death. Objective: to publish the international technical aspects and results of kidney and liver transplantation with donors in asystole; and the ethical-legal elements to support its implementation in Mexico. Results: the Maastricht criteria are used to classify donors in asystole, with graft survival five years post-transplant being 70% when these donors are used. At hepatic level, when organs are obtained from donors in type II asystole, there are more reported cases of ischemic cholangiopathy. There are various technical foundations (the American Heart Association approves efforts to optimize the ethical acquisition of organ donations since ACLS 2019 guidelines), ethical (the Advance Directive Law of Mexico City bases this donation program), legal (the General Health Law on Transplantation does not detail the procurement of organs from donors with irreversible cardiac arrest) and juridical (the general principles of law under article 14 of the Constitution safeguard the actions of health professionals to procure organs from donors in asystole) that support the implementation of the organ donation program in asystole. Conclusions: donation after circulatory death (DCD) is an effective means of expanding the pool of potential donors. Countries with successfully implemented DCD programs have achieved this primarily by establishing national ethical, technical, administrative and legal frameworks, which must be established in Mexico for the initiation of this program.

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