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Brazilian guidelines for the management of brain-dead potential organ donors. The task force of the AMIB, ABTO, BRICNet, and the General Coordination of the National Transplant System

OBJECTIVE: To contribute to updating the recommendations for brain-dead potential organ donor management. METHOD: A group of 27 experts, including intensivists, transplant coordinators, transplant surgeons, and epidemiologists, joined a task force formed by the General Coordination Office of the Nat...

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Autores principales: Westphal, Glauco Adrieno, Robinson, Caroline Cabral, Cavalcanti, Alexandre Biasi, Gonçalves, Anderson Ricardo Roman, Guterres, Cátia Moreira, Teixeira, Cassiano, Stein, Cinara, Franke, Cristiano Augusto, da Silva, Daiana Barbosa, Pontes, Daniela Ferreira Salomão, Nunes, Diego Silva Leite, Abdala, Edson, Dal-Pizzol, Felipe, Bozza, Fernando Augusto, Machado, Flávia Ribeiro, de Andrade, Joel, Cruz, Luciane Nascimento, de Azevedo, Luciano Cesar Pontes, Machado, Miriam Cristine Vahl, Rosa, Regis Goulart, Manfro, Roberto Ceratti, Nothen, Rosana Reis, Lobo, Suzana Margareth, Rech, Tatiana Helena, Lisboa, Thiago, Colpani, Verônica, Falavigna, Maicon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7736434/
https://www.ncbi.nlm.nih.gov/pubmed/33315161
http://dx.doi.org/10.1186/s13613-020-00787-0
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author Westphal, Glauco Adrieno
Robinson, Caroline Cabral
Cavalcanti, Alexandre Biasi
Gonçalves, Anderson Ricardo Roman
Guterres, Cátia Moreira
Teixeira, Cassiano
Stein, Cinara
Franke, Cristiano Augusto
da Silva, Daiana Barbosa
Pontes, Daniela Ferreira Salomão
Nunes, Diego Silva Leite
Abdala, Edson
Dal-Pizzol, Felipe
Bozza, Fernando Augusto
Machado, Flávia Ribeiro
de Andrade, Joel
Cruz, Luciane Nascimento
de Azevedo, Luciano Cesar Pontes
Machado, Miriam Cristine Vahl
Rosa, Regis Goulart
Manfro, Roberto Ceratti
Nothen, Rosana Reis
Lobo, Suzana Margareth
Rech, Tatiana Helena
Lisboa, Thiago
Colpani, Verônica
Falavigna, Maicon
author_facet Westphal, Glauco Adrieno
Robinson, Caroline Cabral
Cavalcanti, Alexandre Biasi
Gonçalves, Anderson Ricardo Roman
Guterres, Cátia Moreira
Teixeira, Cassiano
Stein, Cinara
Franke, Cristiano Augusto
da Silva, Daiana Barbosa
Pontes, Daniela Ferreira Salomão
Nunes, Diego Silva Leite
Abdala, Edson
Dal-Pizzol, Felipe
Bozza, Fernando Augusto
Machado, Flávia Ribeiro
de Andrade, Joel
Cruz, Luciane Nascimento
de Azevedo, Luciano Cesar Pontes
Machado, Miriam Cristine Vahl
Rosa, Regis Goulart
Manfro, Roberto Ceratti
Nothen, Rosana Reis
Lobo, Suzana Margareth
Rech, Tatiana Helena
Lisboa, Thiago
Colpani, Verônica
Falavigna, Maicon
author_sort Westphal, Glauco Adrieno
collection PubMed
description OBJECTIVE: To contribute to updating the recommendations for brain-dead potential organ donor management. METHOD: A group of 27 experts, including intensivists, transplant coordinators, transplant surgeons, and epidemiologists, joined a task force formed by the General Coordination Office of the National Transplant System/Brazilian Ministry of Health (CGSNT-MS), the Brazilian Association of Intensive Care Medicine (AMIB), the Brazilian Association of Organ Transplantation (ABTO), and the Brazilian Research in Intensive Care Network (BRICNet). The questions were developed within the scope of the 2011 Brazilian Guidelines for Management of Adult Potential Multiple-Organ Deceased Donors. The topics were divided into mechanical ventilation, hemodynamic support, endocrine-metabolic management, infection, body temperature, blood transfusion, and use of checklists. The outcomes considered for decision-making were cardiac arrest, number of organs recovered or transplanted per donor, and graft function/survival. Rapid systematic reviews were conducted, and the quality of evidence of the recommendations was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Two expert panels were held in November 2016 and February 2017 to classify the recommendations. A systematic review update was performed in June 2020, and the recommendations were reviewed through a Delphi process with the panelists between June and July 2020. RESULTS: A total of 19 recommendations were drawn from the expert panel. Of these, 7 were classified as strong (lung-protective ventilation strategy, vasopressors and combining arginine vasopressin to control blood pressure, antidiuretic hormones to control polyuria, serum potassium and magnesium control, and antibiotic use), 11 as weak (alveolar recruitment maneuvers, low-dose dopamine, low-dose corticosteroids, thyroid hormones, glycemic and serum sodium control, nutritional support, body temperature control or hypothermia, red blood cell transfusion, and goal-directed protocols), and 1 was considered a good clinical practice (volemic expansion). CONCLUSION: Despite the agreement among panel members on most recommendations, the grade of recommendation was mostly weak. The observed lack of robust evidence on the topic highlights the importance of the present guideline to improve the management of brain-dead potential organ donors.
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spelling pubmed-77364342020-12-17 Brazilian guidelines for the management of brain-dead potential organ donors. The task force of the AMIB, ABTO, BRICNet, and the General Coordination of the National Transplant System Westphal, Glauco Adrieno Robinson, Caroline Cabral Cavalcanti, Alexandre Biasi Gonçalves, Anderson Ricardo Roman Guterres, Cátia Moreira Teixeira, Cassiano Stein, Cinara Franke, Cristiano Augusto da Silva, Daiana Barbosa Pontes, Daniela Ferreira Salomão Nunes, Diego Silva Leite Abdala, Edson Dal-Pizzol, Felipe Bozza, Fernando Augusto Machado, Flávia Ribeiro de Andrade, Joel Cruz, Luciane Nascimento de Azevedo, Luciano Cesar Pontes Machado, Miriam Cristine Vahl Rosa, Regis Goulart Manfro, Roberto Ceratti Nothen, Rosana Reis Lobo, Suzana Margareth Rech, Tatiana Helena Lisboa, Thiago Colpani, Verônica Falavigna, Maicon Ann Intensive Care Research OBJECTIVE: To contribute to updating the recommendations for brain-dead potential organ donor management. METHOD: A group of 27 experts, including intensivists, transplant coordinators, transplant surgeons, and epidemiologists, joined a task force formed by the General Coordination Office of the National Transplant System/Brazilian Ministry of Health (CGSNT-MS), the Brazilian Association of Intensive Care Medicine (AMIB), the Brazilian Association of Organ Transplantation (ABTO), and the Brazilian Research in Intensive Care Network (BRICNet). The questions were developed within the scope of the 2011 Brazilian Guidelines for Management of Adult Potential Multiple-Organ Deceased Donors. The topics were divided into mechanical ventilation, hemodynamic support, endocrine-metabolic management, infection, body temperature, blood transfusion, and use of checklists. The outcomes considered for decision-making were cardiac arrest, number of organs recovered or transplanted per donor, and graft function/survival. Rapid systematic reviews were conducted, and the quality of evidence of the recommendations was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Two expert panels were held in November 2016 and February 2017 to classify the recommendations. A systematic review update was performed in June 2020, and the recommendations were reviewed through a Delphi process with the panelists between June and July 2020. RESULTS: A total of 19 recommendations were drawn from the expert panel. Of these, 7 were classified as strong (lung-protective ventilation strategy, vasopressors and combining arginine vasopressin to control blood pressure, antidiuretic hormones to control polyuria, serum potassium and magnesium control, and antibiotic use), 11 as weak (alveolar recruitment maneuvers, low-dose dopamine, low-dose corticosteroids, thyroid hormones, glycemic and serum sodium control, nutritional support, body temperature control or hypothermia, red blood cell transfusion, and goal-directed protocols), and 1 was considered a good clinical practice (volemic expansion). CONCLUSION: Despite the agreement among panel members on most recommendations, the grade of recommendation was mostly weak. The observed lack of robust evidence on the topic highlights the importance of the present guideline to improve the management of brain-dead potential organ donors. Springer International Publishing 2020-12-14 /pmc/articles/PMC7736434/ /pubmed/33315161 http://dx.doi.org/10.1186/s13613-020-00787-0 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Research
Westphal, Glauco Adrieno
Robinson, Caroline Cabral
Cavalcanti, Alexandre Biasi
Gonçalves, Anderson Ricardo Roman
Guterres, Cátia Moreira
Teixeira, Cassiano
Stein, Cinara
Franke, Cristiano Augusto
da Silva, Daiana Barbosa
Pontes, Daniela Ferreira Salomão
Nunes, Diego Silva Leite
Abdala, Edson
Dal-Pizzol, Felipe
Bozza, Fernando Augusto
Machado, Flávia Ribeiro
de Andrade, Joel
Cruz, Luciane Nascimento
de Azevedo, Luciano Cesar Pontes
Machado, Miriam Cristine Vahl
Rosa, Regis Goulart
Manfro, Roberto Ceratti
Nothen, Rosana Reis
Lobo, Suzana Margareth
Rech, Tatiana Helena
Lisboa, Thiago
Colpani, Verônica
Falavigna, Maicon
Brazilian guidelines for the management of brain-dead potential organ donors. The task force of the AMIB, ABTO, BRICNet, and the General Coordination of the National Transplant System
title Brazilian guidelines for the management of brain-dead potential organ donors. The task force of the AMIB, ABTO, BRICNet, and the General Coordination of the National Transplant System
title_full Brazilian guidelines for the management of brain-dead potential organ donors. The task force of the AMIB, ABTO, BRICNet, and the General Coordination of the National Transplant System
title_fullStr Brazilian guidelines for the management of brain-dead potential organ donors. The task force of the AMIB, ABTO, BRICNet, and the General Coordination of the National Transplant System
title_full_unstemmed Brazilian guidelines for the management of brain-dead potential organ donors. The task force of the AMIB, ABTO, BRICNet, and the General Coordination of the National Transplant System
title_short Brazilian guidelines for the management of brain-dead potential organ donors. The task force of the AMIB, ABTO, BRICNet, and the General Coordination of the National Transplant System
title_sort brazilian guidelines for the management of brain-dead potential organ donors. the task force of the amib, abto, bricnet, and the general coordination of the national transplant system
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7736434/
https://www.ncbi.nlm.nih.gov/pubmed/33315161
http://dx.doi.org/10.1186/s13613-020-00787-0
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