2002, Number 2
Experience in multiple organ procurement
Jiménez DA, Holm CA, Hernández DM, Pérez ML, Muñiz TV
Full text
Language: Spanish
References: 8
Page: 112-115
PDF size: 49.78 Kb.
ABSTRACT
Objective: To inform our experience and results obtained with the multiple organ procurement technique used in 38 cases of organ donations from cadaveric donors. Setting: Third level health care hospital.Design: Retrospective, longitudinal, and observational study.
Material and methods: Review of the clinical records of patients with brain death that were used for multiorgan procurement between June 1995 and June 1997. The technique used and the amount and quality of the obtained organs were assessed.
Results: Thirty-eight multiorgan procurements were performed, the average age of the cadaveric donors was of 19.9 years. There were 31 men and 7 women. Brain death was due to craneo-encephalic trauma in all cases. According to the international classification of the United Network for Organ Sharing (UNOS), 72% of the donors were type-B, 18% were type-C, and 10% were type-A. In all cases, multiple organ harvesting was achieved through a sternal incision to the pubic symphysis, medial sternotomy, aortic dissection, and cannulation above the iliac arteries bifurcation, aortic clamping at the starting point of the aorta, and section of the supradiaphragmatic inferior cava vein to drain thoracic blood; perfusion was performed with MPS in 31 of the cases and with UW-1 in the other seven, the abdominal cavity was flooded with ice, and the abdominal organs were dissected and removed. Renal preservation was accomplished through continuous pulse perfusion in 85% of the obtained renal grafts and simple hypothermia was used in 15%. Cold ischemia lasted an average of 10 h, once the abdominal organs had been removed, the cornea was also excised. A total of 70 corneas, 60 kidneys, 8 hearts, and 2 lungs were obtained. Eight kidneys could not be used. From the kidney transplanted patients, 81.6% of them have a functioning kidney and, from the cardiac transplants, five patients have adequate cardiac function.
Conclusion: The results obtained with the described technique are satisfactory and feasible in our environment; therefore we have abandoned the abdominal harvesting technique, even for just renal grafts, in our service.
REFERENCES