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Effect of posttraumatic donor's disseminated intravascular coagulation in intrathoracic organ donation and transplantation.

Abstract：

INTRODUCTION:Our aim was to evaluate the influence on yield and function of intrathoracic organs from donors after severe cranial trauma complicated by disseminated intravascular coagulation (DIC). MATERIALS AND METHODS:This retrospective observational study in a patient cohort with severe cranial trauma reading to brain death compared the number of harvested thoracic organs among individuals with versus without previous DIC. We examined exclusions for organ donation and their probable relationship to DIC. We also analyzed blood components transfused to normalize coagulation parameters. The organ recipients were followed for 1 month to detect acute graft failure. RESULTS:Among 147 organ donors, 37 were brain dead after suffering severe cranial trauma and 13 met DIC criteria upon admission. We did not observe demographic differences among donors, although there was a trend for DIC donors to be younger (32 +/- 10 vs 40 +/- 21 years old; P = .11). Twenty-eight donors (12 with DIC and 16 without) and 29 donors (13 with DIC and 16 without) met age and medical criteria for potential heart or lung donation, respectively. Donation exclusion was related to trauma instead of DIC itself. We did not find any difference among the number of cardiac and lung organs harvested from organ donors with DIC (67% and 31%, respectively) or without DIC (75% and 44%, respectively). All DIC donors had clinical bleeding and received multiple units of blood products. Organs were harvested 37 +/- 23 (13 to 80) hours after admission. All patients had normalized coagulation parameters at surgery. In the postoperative evolution, none of the cardiac or lung recipients from DIC donors met primary graft failure criteria. CONCLUSIONS:We concluded that hearts and lungs from donors with previous DIC were suitable for transplant recipients.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Valdivia M,Chamorro C,Romera MA,Balandín B,Pérez M

doi

10.1016/j.transproceed.2007.07.052

subject

Has Abstract

pub_date

2007-09-01 00:00:00

pages

2427-8

issue

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(07)00886-X

journal_volume

pub_type

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Effect of posttraumatic donor's disseminated intravascular coagulation in intrathoracic organ donation and transplantation.