Extrahospitalary donors after cardiac dead

Abstract

Introduction: The Madrid Emergency Medical Service (SUMMA112) in collaboration with Madrid's hospitals are employed at a program of donation of patients’ organs that have suffered out-of-hospital cardiac arrest and no response of advanced life support (ALS). These are Maastricht type II donors after cardiac dead. The objective is to describe the results of this program.Methods: Retrospective observational study based on review of emergency medical service database, case histories of donors after cardiac dead, and information provided by transplant units. The following variables were entered into the database: age, sex, transfer hospital, time to arrival on the scene of cardiopulmonary arrest, time to arrival in hospital, number and type of organs retrieved, use of mechanical compression devices, and cause of no donation. The study period was January 2005 to April 2010.Results: 204 cases were transferred as potential donors. Average age 40 (10, 71). 85.5% was males. The cause of cardiorespiratory arrest was unknown 55.7%, cardiological 26.9%, neurological 2%, traumatic 5%, respiratory 3.5% and others 7%. The median time for EMS arrival from alert to the scene was 12′41″ and the interval from the alert to hospital was 83′45″. 149 cases (73%) were valid donors. The transplant organs were 228 kidneys, 35 liver, 108 eye tissue, 84 bone tissue and 16 lungs, a total of 471 organs. The average organs per valid donors were 3.16. 55 cases (27%) were no valid donors by extracorporeal bomb failure (7.2%), family negative (14.6%), judge negative (1.8%), biological reason (56.4%) and others (20%). The results in receipt patient of kidney were about 90% of normal function.Conclusions: The extrahospitalary donors after cardiac dead program has a successfully results with more than 3 organs per patient. The majority of these organs have a normal function in transplant. Introduction: The Madrid Emergency Medical Service (SUMMA112) in collaboration with Madrid's hospitals are employed at a program of donation of patients’ organs that have suffered out-of-hospital cardiac arrest and no response of advanced life support (ALS). These are Maastricht type II donors after cardiac dead. The objective is to describe the results of this program. Methods: Retrospective observational study based on review of emergency medical service database, case histories of donors after cardiac dead, and information provided by transplant units. The following variables were entered into the database: age, sex, transfer hospital, time to arrival on the scene of cardiopulmonary arrest, time to arrival in hospital, number and type of organs retrieved, use of mechanical compression devices, and cause of no donation. The study period was January 2005 to April 2010. Results: 204 cases were transferred as potential donors. Average age 40 (10, 71). 85.5% was males. The cause of cardiorespiratory arrest was unknown 55.7%, cardiological 26.9%, neurological 2%, traumatic 5%, respiratory 3.5% and others 7%. The median time for EMS arrival from alert to the scene was 12′41″ and the interval from the alert to hospital was 83′45″. 149 cases (73%) were valid donors. The transplant organs were 228 kidneys, 35 liver, 108 eye tissue, 84 bone tissue and 16 lungs, a total of 471 organs. The average organs per valid donors were 3.16. 55 cases (27%) were no valid donors by extracorporeal bomb failure (7.2%), family negative (14.6%), judge negative (1.8%), biological reason (56.4%) and others (20%). The results in receipt patient of kidney were about 90% of normal function. Conclusions: The extrahospitalary donors after cardiac dead program has a successfully results with more than 3 organs per patient. The majority of these organs have a normal function in transplant.