Summary

Factors affecting the survival of transplants from donors after prehospital cardiac death

Mateos Rodríguez AA, Andrés Belmonte A, Del Río Gallegos F, Coll E

Affiliation of the authors

SUMMA 112, Universidad Francisco de Vitoria, Madrid, Spain. Hospital Universitario 12 de Octubre, Madrid, Spain. Hospital Clínico San Carlos, Madrid, Spain. Organización Nacional de Trasplantes, Madrid, Spain.

DOI

Quote

Mateos Rodríguez AA, Andrés Belmonte A, Del Río Gallegos F, Coll E. Factors affecting the survival of transplants from donors after prehospital cardiac death. Emergencias. 2017;29:167-72

Summary

Objective.

To evaluate factors that influence the survival of transplanted organs from donors after prehospital cardiac death.

Methods.

Retrospective observational study of data collected from hospital emergency service records. Information included prehospital cardiac deaths evaluated as donors as well as patients who received transplants.

Results.

Two hundred cases from 2008 through 2011 were studied. Sixty-nine potential donors (34.5%) were rejected. Three hundred organs were extracted from the remaining 131 donor cases, to yield a mean (SD) of 2.32 (0.83) transplanted organs/donor or 1.52 (1.29) organs/potential donor. One hundred fifty-two potential donors (76%) were treated with mechanical cardiopumps during transport. We detected no significant differences between cases transported with manual chest compressions and cases treated with cardiopumps regarding age (40.1 vs 43.5 years, P=.06), responder arrival times (13 min 54 s vs 12 min 54 s, P=.45), or transport times (1 h 27 min vs 1 h 32 min).

However, case transported with manual chest compressions yielded significantly more kidneys (mean, 1.96/potential donor) than those transported with cardiopump compressions (mean, 1.38/potential donor) (P=.008). Eleven of the 229 kidneys harvested (4%) were not transplanted. The median (interquartile range) serum creatinine concentrations after kidney transplants at 6 and 12 months, respectively, were 1.37 (1.10–1.58) mg/dL and 1.43 (1.11–1.80) mg/dL.

Conclusions.

Our findings suggest that the use of a cardiopump reduces donor recruitment. Long-term creatinine levels are similar after transplantation of kidneys from donors transported with a cardiopump or with manual compressions.

 

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