Epidemiological Characteristics and Management of Multi-organ Donors in an Intensive Care Unit: An Eight-Year Retrospective Study.

Autor:	Sanchez García LE; Transplant and Donation Department, Regional General Hospital 1 of the Mexican Social Security Institute, Queretaro, MEX.; Faculty of Medicine, Autonomous University of Queretaro, Queretaro, MEX., Pérez Peña NI; Transplant and Donation Department, Regional General Hospital 1 of the Mexican Social Security Institute, Queretaro, MEX.; Faculty of Medicine, Autonomous University of Queretaro, Queretaro, MEX., Aguilar Rodríguez F; Transplant and Donation Department, Regional General Hospital 1 of the Mexican Social Security Institute, Queretaro, MEX.; Faculty of Medicine, Autonomous University of Queretaro, Queretaro, MEX., Tolentino Pérez DE; Faculty of Medicine, Autonomous University of Queretaro, Queretaro, MEX., Velarde Luján HD; Transplant and Donation Department, Regional General Hospital 1 of the Mexican Social Security Institute, Queretaro, MEX.; Faculty of Medicine, Autonomous University of Queretaro, Queretaro, MEX., García Romero JM; Transplant and Donation Department, Regional General Hospital 1 of the Mexican Social Security Institute, Queretaro, MEX.; Faculty of Medicine, Autonomous University of Queretaro, Queretaro, MEX., Villegas Amador FO; Transplant and Donation Department, Regional General Hospital 1 of the Mexican Social Security Institute, Queretaro, MEX.; Faculty of Medicine, Autonomous University of Queretaro, Queretaro, MEX., Montoya Vázquez A; Transplant and Donation Department, Regional General Hospital 1 of the Mexican Social Security Institute, Queretaro, MEX.; Faculty of Medicine, Autonomous University of Queretaro, Queretaro, MEX., Diaz Ugalde JA; Faculty of Medicine, Autonomous University of Queretaro, Queretaro, MEX., García Hernández I; Transplant and Donation Department, Regional General Hospital 1 of the Mexican Social Security Institute, Queretaro, MEX.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Oct 15; Vol. 16 (10), pp. e71556. Date of Electronic Publication: 2024 Oct 15 (Print Publication: 2024).
DOI:	10.7759/cureus.71556
Abstrakt:	Introduction: Patients with brain death are the primary source of organs for transplantation worldwide. Recognizing patients with this diagnosis, providing proper care, and effectively managing them in an intensive care unit (ICU) has been shown to increase donation rates in leading countries. The increasing demand for organs compared to the available number for transplantation heightens the responsibility of caring for potential donors. Methods: An observational, cross-sectional, descriptive, and retrospective study was undertaken through the analysis of cases involving multiorgan donors diagnosed with brain death. This data was obtained from the coordination of donation and procurement at the Regional General Hospital 1 of the Mexican Institute of Social Security in Querétaro. The study encompassed the duration from January 1, 2016 to December 31, 2023. Statistical Analysis: A database was created in the Excel program and subsequently, the analysis of the variables identified was carried out in the IBM SPSS Statics 25 software (IBM Corp., Armonk, NY). Qualitative variables were analyzed using contingency tables, frequency tables, and statistical correlation tables. For quantitative variables, the analysis included averages, percentages, means, medians, modes, variances, and standard deviations. Results: A total of 83 patients diagnosed with brain death were identified, of whom 56 became multiorgan donors. Thirty patients were excluded from donation, with the majority (19) due to family refusal. The primary age group was 10-20 years, accounting for 23.21% of cases. The mean age was 34.86 years. 71.43% of donors were male and 28.57% were female. The most frequent admission diagnosis was severe traumatic brain injury (46.43%). 56.6% of patients were admitted to the hospital with a Glasgow Coma Scale (GCS) score of 3 points. Brain death diagnosis was confirmed via angiography in 80.4% of cases. The average length of stay was 3.95 days. The average weight was 71.19 kg. The average height was 166 cm, and the mean BMI was 25.30. Forty patients had blood type O positive, accounting for 71.4%. A total of 255 organs and tissues were procured from 2016 to 2023: 103 kidneys, 97 corneas, 41 livers, six hearts, four skin and bone tissue derivatives, three pairs of lungs, and one heart valve. Hormone replacement therapy was not used in 55.4% of cases. Combined thyroid hormone and steroid regimen was used in nine patients (16.1%), and desmopressin was used in 12 patients (21.4%). During ICU stay, 69.6% of patients required norepinephrine to achieve perfusion goals. Conclusions: The epidemiological profile characterizing the multiorgan donor at Regional Hospital 1 in Querétaro was typically male, with a mean age of 34.86 years, no comorbidities, presenting with severe traumatic brain injury upon arrival at the emergency department with a GCS score of 3 points. Norepinephrine was the most commonly used vasopressor, and the majority of patients did not meet hemodynamic criteria for initiating hormone replacement therapy. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Review Board of Regional General Hospital 1 of the Mexican Social Security Institute, Queretaro, Mexico issued approval R-2024-2201-117. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Sanchez García et al.)
Databáze:	MEDLINE
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