Intensive care to facilitate organ donation. ONT-SEMICYUC recommendations
Med Intensiva (Engl Ed). 2021 May;45(4):234-242.
doi: 10.1016/j.medin.2019.09.018.
Epub 2019 Nov 15.
[Article in
English,
Spanish]
Authors
D Escudero Augusto
1
, F Martínez Soba
2
, B de la Calle
3
, A Pérez Blanco
4
, B Estébanez
5
, J Velasco
6
, M J Sánchez-Carretero
7
, T Pont
8
, J M Pérez Villares
9
, N Masnou
10
, M C Martín Delgado
11
, E Coll
4
, D Perojo
4
, D Uruñuela
4
, B Domínguez-Gil
4
Affiliations
- 1 Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Coordinación de Trasplantes, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Grupo de Investigación Microbiología Traslacional, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, España. Electronic address: lolaescudero@telefonica.net.
- 2 Servicio de Medicina Intensiva, Hospital San Pedro, Logroño, La Rioja, España; Coordinación de Trasplantes, Hospital San Pedro, Logroño, La Rioja, España.
- 3 Servicio de Medicina Intensiva, Hospital Universitario Gregorio Marañón, Madrid, España; Coordinación de Trasplantes, Hospital Universitario Gregorio Marañón, Madrid, España.
- 4 Organización Nacional de Trasplantes (ONT), Madrid, España.
- 5 Coordinación de Trasplantes, Hospital Universitario La Paz, Madrid, España; Servicio de Medicina Intensiva, Hospital Universitario La Paz, Madrid, España.
- 6 Servicio de Medicina Intensiva, Hospital Son Espases, Palma, España.
- 7 Coordinación autonómica de Trasplantes de Castilla-La Mancha, Toledo, España.
- 8 Coordinación de Trasplantes, Hospital Universitario Vall d'Hebron, Barcelona, España.
- 9 Coordinación autonómica de Trasplantes de Andalucía, Granada, España.
- 10 Coordinación de Trasplantes, Hospital Universitario Dr. Josep Trueta, Girona, España.
- 11 Servicio de Medicina Intensiva, Hospital Universitario de Torrejón, Facultad de Medicina, Universidad Francisco de Vitoria, Torrejón de Ardoz, Madrid, España.
Abstract
Intensive care to facilitate organ donation (ICOD) is defined as the initiation or continuation of life-sustaining measures, such as mechanical ventilation, in patients with a devastating brain injury with high probability of evolving to brain death and in whom curative treatment has been completely dismissed and considered futile. ICOD incorporates the option to organ donation allowing a holistic approach to end-of-life care, consistent with the patients wills and values. Should the patient not evolve to brain death, life-supportive treatment must be withdrawal and controlled asystolia donation could be evaluated. ICOD is a legitimate practice, within the ethical and legal regulations that contributes increasing the accessibility of patients to transplantation, promoting health by increasing deceased donation by 24%, and with a mean of 2.3 organs transplanted per donor, and collaborating with the sustainability of health-care system. This ONT-SEMICYUC recommendations provide a guide to facilitate an ICOD harmonized practice in spanish ICUs.
Keywords:
Brain death; Donación de órganos; Muerte cerebral; Non-therapeutic elective ventilation; Organ donation; Transplantation; Trasplantes; Ventilación electiva no terapéutica.
Copyright © 2019. Publicado por Elsevier España, S.L.U.