Standard versus extended criteria graft procurement. Experience at the Hospital de Especialidades La Raza
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Keywords
Expanded Criteria Donor, Standard Donor, Tissue and Organ Procurement, Organ Transplantation, Brain Death
Abstract
Background: In Mexico, there are 23 158 patients waiting for an organ or tissue transplant. The increasing demand of grafts justifies the use of expanded criteria donors; however, not even all standard grafts have been procured.
Objective: To identify the associated factors to the decision of not procuring grafts from brain death donors whose donation was consented.
Method: Retrospective cohort, univariate and multivariate analysis. 35 donation files with brain death were included from 2014 to 2019. Groups in which the heart wasn’t procured versus those in which it was procured were compared; same comparisons were made for liver, kidney, skin, bone tissue and corneas.
Results: 20 women (57.1%), 15 men (42.9%) average age of 43.8 ± 16.4 years. High-dose of inotropic or norepinephrine use increased the probability of cardiac procurement (odds ratio [OR] 0.57; 95% confidence interval [95%CI]: 0.0-0.5). It was not detected a sensitive and specific variable for decision making at liver procurement. Implementation of two or more diagnostic methods for BD were associated with kidney loss (OR: 10; 95%CI: 1.2-78.1). Organs and tissues met standard criteria; however, 76 (41.5%) were not procured.
Conclusions: Non-procurement associated factors were different from the standard donor established criteria. It is necessary to follow clear procurement criteria, in order to reduce viable grafts loss.
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