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Objetivo. Analizar los pasos necesarios para conseguir una donacion efectiva de organos, describir nuestra experiencia y desarrollar una serie de propuestas para mejorar las tasas de donacion. Metodo. Estudio de serie de casos, de forma retrospectiva fueron recogidas un grupo de variables demograficas y las caracteristicas que permitian definir a los pacientes en: posibles donantes, donantes potenciales, donantes reales y donantes efectivos. Tambien fueron recogidas las causas de ME y de perdidas de donantes. Resultados. Durante los anos 1998 al 2004 fueron evaluados 248 pacientes con una edad media de 40.9±13.5 anos, siendo el 70.2% hombres (174), a 86 de estos pacientes se les diagnostico ME (34.7%) llegando a ser donantes reales 29 (33.7%) y de estos donantes efectivos 20 (68.9%), en los donantes solo fueron extraidos los rinones. La tasa de donantes de organos por millon de poblacion en los primeros cinco anos fue muy irregular, estabilizandose en los anos 2003 y 2004 muy cercana a la obtenida por el pais. La causa de ME predominante fue la enfermedad cerebrovascular hemorragica. Las causas de perdidas de donantes de organos mas frecuentes fueron el fallo del mantenimiento y la negativa familiar. Tanto por falla del mantenimiento como por las negativas familiares se observo una disminucion progresiva con el transcurso de los anos. Conclusion. El estudio de siete anos de trabajo en la donacion de organos permitio conocer las areas de mejora quedando resumidas en: incremento de la deteccion de posibles donantes, mejorar el acercamiento familiar y el mantenimiento del donante, lograr donaciones multiorganicas e iniciar la obtencion de tejidos. Palabras clave: Donante; Donacion de organos; Procuracion de organos y tejidos (MeSH). Evolution of Organ Donation and Characteristic of Donners in a Cuban University Hospital ABSTRACT Objective. To analyze the necessary steps to get an effective organ donation, to describe our experience, and to develop a series of proposal to improve the donations rate. Method. It is a study of series of cases. In a retrospective way, some demographic variables were analyzed, as well as the characteristics that allowed us to define the patients into: possible donners, potential donners, real donners and effective donners. The causes of brain death (neurological death) and the loss of donners were also analyzed. Results. From 1998 to 2004, 248 patients were evaluated with an average age of 40.9±13.5. Out this total 70.2% were males (174 patients). From this group of male patients, 86 were diagnosed with brain death (34.7%) only 29 of them (33.7%) were real donner. From this real donners, 20 patients (68.9%) were effective donners. In all these donners, the kidneys were the only one organs used. The organ donner's rate per million inhabitants in the first 5 years was very irregular, audit was steady in the years 2003 and 2004 which was very closed to the one obtained in the country. The most predominant cause of brain death was the hemorrhagic cerebrovascular disease. The most frequent causes of organ donner's loss were the damage in the human body and the family refusal. These two elements have diminished progressively within the pass of the time. Conclusion. A seven year study of the organ's donation allowed us to know the areas of improvement which are summarized in aspects such as: an increment in the better conditions of the donner; and also to achieve multi-organic donation and to start with the attainment of tissue. Key words: Donor; Organ Donation; Tissue and Organ Procurement (MeSH). |
