Prehospital non-heart-beating donors: 4 years’ experience of the SUMMA112 emergency service

Mateos Rodríguez AA, Cepas Vázquez J, Navalpotro Pascual JM, Martín Maldonado ME, Barba Alonso C, Pardillos Ferrer L, Andrés Belmonte A

Background and objective: The emergency medical service of Madrid (SUMMA112)

participates in a program to facilitate organ donation from patients in cardiorespiratory

arrest who do not respond to advanced cardiopulmonary resuscitation maneuvers before

arriving at the hospital. Patients who meet the criteria for inclusion are transferred to a

transplant unit for extraction of organs while resuscitation maneuvers continue. The aim

of this study was to determine time intervals under the program, the percentage of

donors, the characteristics of donors and nondonors, and the number of organs obtained.

Material and methods: Descriptive, retrospective study of donors and organs obtained

through the participation of SUMMA112 in the donation program over a 4-year period

(2005-2009), based on review of medical records. The following data were extracted: age,

sex, time until arrival of the ambulance, time until arrival at the hospital, number of organs

donated, and type of organ donated. We also recorded the reason for not donating:

patient refusal, family refusal, pump failure, biologically nonviable state, and other.

Results: A total of 132 cases (85% male) were found. The mean age of patients was 40

years. The mean time until arrival of emergency caregivers at the scene was 14 minutes, 55

seconds. The mean time until arrival at the hospital was 92 minutes. Three hundred fifty-six

organs (158 kidneys, 16 livers, 97 corneas, 72 bone tissues, and 13 lungs) were obtained,

corresponding to 2.3 organs per patient; 27.3% of the patients were nonviable donors.

There were no age or sex differences between viable and nonviable donors. Reasons for not

donating were failure of extracorporeal circulation (8.3%), refusal of the family (13.9%) or

the patient while alive (2.8%), biologically nonviable state (44.4%), and other (30.6%).

Conclusion: A considerable number of organs are donated through this program, which helps

to solve the problem of lengthening transplant wait lists.

Andrés Belmonte A, Barba Alonso C, Cepas Vázquez J, Martín Maldonado ME, Mateos Rodríguez AA, Navalpotro Pascual JM, Pardillos Ferrer L