Estimation of potential donors after cardiocirculatory death in Elche University General Hospital (Alicante, Spain)

Abstract

Objective: To evaluate the number and characteristics of potential organ donors among cardiocirculatory death cases.

Design and setting: A retrospective observational study was made of individuals between 15-65 years of age who died in the period 2006-2014 in Elche University General Hospital (Alicante, Spain).

Intervention: A univariate analysis and binary logistic regression predictive model were performed to discriminate factors related to donation contraindication.

Variables of interest: Identification of patients with donation contraindication.

Results: Of the 1510 patients who died in the mentioned period, 1048 were excluded due to the application of exclusion criteria; 86 due to evolution towards brain death; and 20 due to losses. A total of 356 patients were analyzed, divided into two groups: 288 in non-heart beating donation II and 68 in non-heart beating donation III. Seventy patients were found to be potential non-heart beating donation II and 10 were found to be potential non-heart beating donation III, which could increase donation activity by 8-9 donors a year. The patients died in the ICU, Resuscitation, Emergency Care, Internal Medicine, Digestive Diseases and Neurology. The following protective factors against organ donation contraindication were identified: death in Emergency Care, cardiorespiratory arrest before or during admission, and heart, respiratory and neurological disease as the cause of admission. Death in Internal Medicine was associated to an increased risk of donation contraindication.

Conclusions: Implementing a non-heart beating donation protocol in our hospital could increase the donation potential by 8-9 donors a year.

Keywords: Cardiocirculatory death; Cardiocirculatory donors; Donación en asistolia; Limitación de tratamientos de soporte vital; Limitation of life-sustaining treatments; Muerte cardiocirculatoria; Potenciales donantes; Potential donors.