Organ Donation after unexpected death determined by circulatory criteria
Section: Ethics and Society
How to quote
Ortega Deballón IM, de la Plaza Horche E. Programa de donación de órganos tras muerte inesperada por criterios circulatorios. Metas Enferm 2013; (4):64-71.
Authors
1Iván Mª Ortega Deballón, 2Edurne de la Plaza Horche
Position
1Enfermero. Licenciado en Derecho. Especialista en Responsabilidad Sanitaria y Experto en Bioética. Enfermero de Emergencias. 2Enfermera UVI móvil 112. Instructora de soporte vital avanzado.
Contact address
Iván Mª Ortega Deballón. Helicopter Emergency Medical Service Madrid-112. Parque de Bomberos. Carretera A-1, km 68. 28752 Lozoyuela (Madrid).
Contact email: Iviortega@gmail.com
Abstract
Methodology: bibliographic review regarding current recommendations on resuscitation, focused on management of cardiorespiratory arrest (CRA) with a potentially reversible cause, identifying those techniques and treatments which are being used at an international level. The following databases were used: PubMed, CINAHL, CUIDEN and Cochrane Library. The review included articles in English, French and Spanish until 2012. The following variables were systematized: patient profile which benefits with non-conventional CRA measures, techniques and treatments implemented, and rate of survival without neurological deficit (Cerebral Performance Categories Scale, CPC). At the same time, a review was conducted for uDCDD programs in Spain, France and the United States, analyzing these variables: historical emergence, consensus documents, defining criteria and changes in terminology; there was also an active involvement in official forums from national and international agencies associated with organ donation.
Results and conclusions: DCD programs (Donation after Cardiac Determination of Death) have undergone modifications in terms of their nomenclature. In Spain, the uDCDD program, initiated in 1995, was called “Donantes a Corazón Parado” (“Non-Heart-Beating Donors”); and this triggered criticism, as the terminology was considered ambiguous. It was claimed that it could be interpreted that patient’s death had not occurred prior to organ extraction, which would violate the so-called rule of dead donors. Nursing staff represent a professional group which is actively involved in each one of the links and elements of the complex system which form the uDCDD programs. Professional excellence requires protocols in agreement with the status of science and art, with ethics and deontology, with lex artis and with trust by the society.
Keywords:
death by circulatory criteria; encephalic death; non conventional CRA programs; organ donationuDCDD programs
Versión en Español
Título:
Donación de órganos tras muerte inesperada por criterios circulatorios
