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Journal Article

Citation

Bustos JL, Surt K, Soratti C. Transplant. Proc. 2006; 38(10): 3697-3699.

Affiliation

National Institute for Organ Donation and Transplantation and INCUCAI, Buenos Aires, Argentina.

Copyright

(Copyright © 2006, Elsevier Publishing)

DOI

10.1016/j.transproceed.2006.10.046

PMID

17175371

Abstract

BACKGROUND: In Argentina, the rate of cadaveric organ donation per million inhabitants has recently increased to 10.5 (it was previously <7). PURPOSE: To overcome this challenge, the National Institute for Organ Donation and Transplantation (INCUCAI) created a proactive donor detection plan performed by intensive care unit (ICU) physicians (hospital transplantation coordinators) from 90 selected hospitals across the country. METHODS: A prospective, observational study of patients in severe coma status was conducted from September 2003 to December 2005. We enrolled hospitalized patients who displayed a Glasgow Coma Scale (GCS) of 7 or less and who were admitted to ICUs. Data included demographics, etiology of coma, cardiac arrest, brain death, discharge or derivation, and positive/negative donation. RESULTS: Among 9841 enrolled patients, we excluded 498 who were discharged to another hospital or had unknown outcomes, leaving 9343 for analysis including 64% males and 36% females of overall mean age 50 +/- 19 years (adults) and 5 +/- 4 years (children). Herein, we have highlighted the high risk of death during the first 2 days in the ICU of patients with GCS 7 or less. Gunshot to the head-injured patients and those with hemorrhagic strokes were less likely to survive. In this study, cardiac arrest events and organ donors (OD) GCS 7 or less ratios emerged as quality control markers of ICU care, unraveling problems of potential donor maintenance or inadequate policies. CONCLUSIONS: The GCS 7 or less surveillance program seemed to be a valuable tool for identifying organ donors and potentially treatable events, such as the high rate of cardiac arrest observed in this study.

Language: en

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