AUTHOR=Pérez-Blanco Alicia , Acevedo María , Padilla María , Gómez Aroa , Zapata Luis , Barber María , Martínez Adolfo , Calleja Verónica , Rivero María C. , Fernández Esperanza , Velasco Julio , Flores Eva M. , Quindós Brígida , Rodríguez Sergio T. , Virgós Beatriz , Robles Juan C. , Nebra Agustín C. , Moya José , Trenado Josep , García Nieves , Vallejo Ana , Herrero Eugenio , García Álvaro , Rodríguez Maria L. , García Fernando , Lara Ramón , Lage Lucas , Gil Francisco J. , Guerrero Francisco J. , Meilán Ángela , Del Prado Nayade , Fernández Cristina , Coll Elisabeth , Domínguez-Gil Beatriz TITLE=Assessing Outcomes of Patients Subject to Intensive Care to Facilitate Organ Donation: A Spanish Multicenter Prospective Study JOURNAL=Transplant International VOLUME=37 YEAR=2024 URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2024.12791 DOI=10.3389/ti.2024.12791 ISSN=1432-2277 ABSTRACT=

Intensive Care to facilitate Organ Donation (ICOD) consists of the initiation or continuation of intensive care measures in patients with a devastating brain injury (DBI) in whom curative treatment is deemed futile and death by neurological criteria (DNC) is foreseen, to incorporate organ donation into their end-of-life plans. In this study we evaluate the outcomes of patients subject to ICOD and identify radiological and clinical factors associated with progression to DNC. In this first prospective multicenter study we tested by multivariate regression the association of clinical and radiological severity features with progression to DNC. Of the 194 patients, 144 (74.2%) patients fulfilled DNC after a median of 25 h (95% IQR: 17–44) from ICOD onset. Two patients (1%) shifted from ICOD to curative treatment, both were alive at discharge. Factors associated with progression to DNC included: age below 70 years, clinical score consistent with severe brain injury, instability, intracranial hemorrhage, midline shift ≥5 mm and certain types of brain herniation. Overall 151 (77.8%) patients progressed to organ donation. Based on these results, we conclude that ICOD is a beneficial and efficient practice that can contribute to the pool of deceased donors.