Valdecilla researchers develop treatment strategies for preserving donor organs

Eduardo Miñambres of Intensive Care, Transplant coordinator Valdecilla Hospital and researcher IDIVAL led the study " An intensive treatment lung or protocol does not Have negative influence on other grafts: a multicentre study " . Together with specialists from the areas affected, showed conservation outcomes donor tissue through a triple therapy to preserve these tissues and based in protective mechanical ventilation, invasive hemodynamic monitoring with water restriction and use of hormone therapy. This proposal treatment that attempts to alleviate the functional impairment that occurs after brain death antagonists include strategies to the needs of perfusion of all organs be donated, such as fluid restriction, on the one hand beneficial for the lung but harmful to the kidneys; the use of high levels of PEEP on the respirator that benefits and harms lung donor and hemodynamic steroid use which alters blood glucose and can cause osmotic diuresis ...

To clarify the possible adverse effect of this treatment in other organs be donated a prospective multicenter study with 6 hospitals in the country, which has included 618 multiple organ donors, which have demonstrated that intensive treatment this proposal does not affect the donor was performed any way the rate obtaining be donated other organs (heart, liver, pancreas and kidneys) actually increases the rate of production of the cardiac grafts. It also does not detrimental to the survival of the recipients of donated organs (lungs, heart, liver, kidneys and pancreas) once the transplant is performed.

To clarify the possible adverse effect of this treatment in other organs be donated a prospective multicenter study with 6 hospitals in the country, which has included 618 multiorgan donors, and where we have shown that this proposal was conducted intensive treatment the donor does not affect at any rate to obtain the other be donated organs (heart, liver, pancreas and kidneys) mode, actually increases the rate of production of the cardiac grafts. It also does not detrimental to the survival of the recipients of donated organs (lungs, heart, liver, kidneys and pancreas) once the transplant is performed.

A significant study results given the limitation of both the donation as valid organ preservation, conservation thereof and to transplantadora activity, matter as mentioned above affects mainly thoracic organs after the release of catecholamines, neurogenic edema, myocardial microinfartos, etc ... that occur in situations of cerebral engagement.
the starting point of this multicenter study started after the demonstration of several researchers Valdecilla-IDIVAL that after intensive treatment performed during the 2014 donors multi-organ lungs doubled their rate obtained with this treatment.

This project has been funded by the Foundation Mutua Madrileña (FMM 13/06; Principal Investigator: Eduardo Miñambres)

(1) Miñambres E, Coll E, Duerto J, Suberviola B, Mons R, Cifrian JM, Ballesteros MA.
Effect of an intensive lung donor-management protocol on lung transplantation outcomes.
J Heart Lung Transplant 2014;33:178-84

(2) E Miñambres, Pérez-Villares JM, Boy-Fernandez M, Zabalegui A, Dueñas-Jurado JM, Mysis M, Mosteiro F, G Rodriguez-Caravaca, Coll E.
Lung donor treatment protocol in brain-dead Donors: A multicenter . study
J Heart Lung Transplant 2015; 34: 773-80