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Development of a Non–Heart-Beating Donor Program and Results After the First Year. [artículo]

Por: Ávila Martínez, Régulo José [Cirugía Torácica] | Cortés Guerrero, Manuel [Anestesiología y Reanimación] | Martín de Nicolás Serrahima, José Luis [Cirugía Torácica] | Pablo Gafas, Alicia de [Neumología] | Díaz-Hellín Gude, Vicente [Cirugía Torácica] | Gámez García, Pablo [Cirugía Torácica] | Toldos González, Oscar [Anatomía Patológica] | Hermoso Alarza, Fátima [Cirugía Torácica] | Juarros Monteagudo, Lourdes [Medicina Física y Rehabilitación] | Mariscal de Alba, María Andrea [Cirugía Torácica] | Marrón Fernández, María del Carmen [Cirugía Torácica] | Martínez Pueyo, José Ignacio [Cirugía General y Aparato Digestivo] | Meneses Pardo, José Carlos [Cirugía Torácica] | Zuluaga Bedoya, Mauricio [Cirugía Torácica] | López López, Eloisa [Anestesiología y Reanimación].
Colaborador(es): Servicio de Cirugía Torácica | Servicio de Cirugía General y del Aparato Digestivo | Servicio de Anestesiología y Reanimación | Servicio de Neumología | Servicio de Medicina Física y Rehabilitación.
Editor: Transplantation Proceedings, 2012Descripción: 44(7):2047-9.Recursos en línea: Solicitar documento Resumen: Our lung transplant unit began activity in October 2008. We have performed 37 lung transplants with a hospital mortality of 2.7% (n = 1). The need for a greater number of donors and the presence of an already existent non-heart-beating donor (NHBD) program for abdominal grafts and tissues encouraged us to consider assessing lung grafts from these donors. It was necessary to develop a new multiorgan preservation methodology, "bithermia preservation." The clinical experience with which during the first year June 2010 to July 2011, including 15 NHBDs is presented herein. The chest x-ray was normal in 6 donors (40%) and 7 had pulmonary infiltrates. Bronchoscopy was normal in 8 donors (53%) but 3 had abundant bleeding airway secretions and signs of bronchoaspiration. Preservation procedures were performed in 6 donors. Pulmonary functional evaluation in 4 donors showed gas measurements to be adequate in 75% of cases. Three double-lung grafts were judged to be valid for implantation, among which we performed 3 lung transplantations, 1 bilateral and 2 unilaterals, while 2 grafts were offered to the National Transplant Organization for other units. No transplant suffered primary graft dysfunction; all 3 showed excellent function allowing early extubation in 2 cases. There was no in-hospital mortality. All 3 patients are alive and leading normal lives; none has bronchiolitis obliterans syndrome. In conclusion, the "bithermia preservation" methodology achieved adequate lung preservation in NHBDs, allowing liver, kidneys, and lungs to be obtained from the same donor.
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Formato Vancouver:
Meneses JC, Gámez P, Mariscal A, Marrón C, Díaz-Hellín V, Cortes M, et al. Development of a non-heart-beating donor program and results after the first year. Transplant Proc. 2012 Sep;44(7):2047-9.

PMID: 22974905

Contiene 8 referencias

Our lung transplant unit began activity in October 2008. We have performed 37 lung transplants with a hospital mortality of 2.7% (n = 1). The need for a greater number of donors and the presence of an already existent non-heart-beating donor (NHBD) program for abdominal grafts and tissues encouraged us to consider assessing lung grafts from these donors. It was necessary to develop a new multiorgan preservation methodology, "bithermia preservation." The clinical experience with which during the first year June 2010 to July 2011, including 15 NHBDs is presented herein. The chest x-ray was normal in 6 donors (40%) and 7 had pulmonary infiltrates. Bronchoscopy was normal in 8 donors (53%) but 3 had abundant bleeding airway secretions and signs of bronchoaspiration. Preservation procedures were performed in 6 donors. Pulmonary functional evaluation in 4 donors showed gas measurements to be adequate in 75% of cases. Three double-lung grafts were judged to be valid for implantation, among which we performed 3 lung transplantations, 1 bilateral and 2 unilaterals, while 2 grafts were offered to the National Transplant Organization for other units. No transplant suffered primary graft dysfunction; all 3 showed excellent function allowing early extubation in 2 cases. There was no in-hospital mortality. All 3 patients are alive and leading normal lives; none has bronchiolitis obliterans syndrome. In conclusion, the "bithermia preservation" methodology achieved adequate lung preservation in NHBDs, allowing liver, kidneys, and lungs to be obtained from the same donor.

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