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2010, Number 2

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Med Crit 2010; 24 (2)

Causes of failure to obtain organs for transplant

Luviano GJA, Bravo ML
Full text How to cite this article

Language: Spanish
References: 11
Page: 90-93
PDF size: 40.31 Kb.


Key words:

Brain death, organ donation, craniectomy.

ABSTRACT

Introduction: Organ donation dependent on the rate of mortality and confirmation of brain death.
Objective: To identify and analyze the causes of failure in organ donation.
Method: A prospective, descriptive and observational. They followed up the patients with clinical diagnosis of brain death (MCC) in the Intensive Care Unit (ICU) in the Trauma Unit of Medical Specialty Care in Trauma (UMAE 21) in Monterrey, Nuevo Leon Mexico during January -December 2008. Diagnosis is made by finding no motor response, absence of stem reflexes and spontaneous breathing with no evidence of apnea; the confirmation was made through panangiographic brain. Collected the following demographic data: age, sex, diagnosis, time of clinical brain death, type of neurosurgery, intracranial pressure curve, and results of panangiographic, acceptance or rejection of the donation.
Results: We present data from 30 patients with MCC. In 93% (28) of cases there was no donation. The main causes are: 28.5% (8) the panangiographic not confirm the diagnosis of brain death to report the presence of flow in the lower parts of the brain in 28.5% (8) does not allow the deteriorating hemodynamic studies in 28.5% (8) legal administrative problems. In 7 (85%) of the 8 cases that reported the presence panangiographic blood flow decompressive craniotomy had been carried. In three cases in which no reported panangiographic blood flow had not been performed craniectomy. Applying Fisher gives a p = 0.03 so the craniectomy is associated with the presence of flow in panangiographic.
Conclusions: The rate of loss of potential donors is high; the decompressive craniectomy is associated with the presence of cerebral blood flow.


REFERENCES

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  2. Baron L, Shemie S, Teitelbaum J, Doig Ch. Brief review: History, concept and controversies in the neurological determination of death. Can J Anesth 2006;53(6):602-608.

  3. Cloutier R, Barab D, Morin J, Dandavino R, Marleeau D, Naud A, Ganon R, Billard M. Brain death diagnosis and evaluation of the number of potential organ donors in Quebec hospitals. Can J Anesth 2006;53(7):716-721.

  4. Gómez-Trejo JC, Portilla-Flores VH, Urbina-Guerrero R, Bazán Borges A. Principales motivos de aceptación y rechazo para la donación de órganos. Experiencia del Hospital Juárez de México. Rev Hosp Jua Méx 2005;72(2):55-58.

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Med Crit. 2010;24