From Neuro-Resuscitation to Organ Donation

Abstract

Introduction: Encephalic death (ED) is one of the consequences of severe head trauma (TBI), and the donor in a state of encephalic death is an unavoidable solution to the shortage of transplants. The aim of our study was to detect the transition to ME in MCT and to assess the possibility of performing multi-organ retrieval from the deceased donor. Material and Method: prospective study of TCGs admitted to the Salim Zemirli health hospital who had progressed to ME, it began in February 2017 over a period of three years. We collected the following data, incidence of ME, age, sex, medical history, Glasgow score on admission, pupil status of donors in ME, mean time to onset of ME, mean duration of graft resuscitation, availability of monitoring, paraclinical investigations and treatment necessary for the management of a donor in ME. The results: A total of 175 MCTs were included, 16% of these MCTs were found to be in the ME state, the diagnosis of ME was clinical with paraclinical confirmation by transcranial doppler, these donors benefited from therapeutic management without limitation of care. The average age was 35 ± 12 years, medical history was present in 35.71% of cases. The average Glasgow score was 5.63 ± 0.324, with pupillary anomalies such as anisocoria in 28.57% and mydriasis in 21.42%. The average time to onset of ME was 3 ± 1.23 days; the average resuscitation time was 44.06 ±8.79 hours; EEG was not available in our department. For the treatment of diabetes insipidus, we noted the absence of desmopressin. Conclusion: Organ harvesting from a deceased donor is technically possible in our establishments.