Diretrizes para manutenção de múltiplos órgãos no potencial doador adulto falecido: parte I. Aspectos gerais e suporte hemodinâmico

Westphal, Glauco Adrieno; Filho, Milton Caldeira; Vieira, Kalinca Daberkow; Zaclikevis, Viviane Renata; Bartz, Miriam Cristine Machado; Wanzuita, Raquel; Teixeira, Cassiano; Franke, Cristiano Augusto; Machado, Fernando Osni; Friedman, Gilberto; Andrade, Jaqueline Inês Alves de; Matos, Jorge Dias de; Lamgaro, Delson Morilo; Silva, Eliézer; Costa, Gerson; Coelho, Maria Emília; Oliveira, Mirela Cristine de; Youssef, Nazah Cherif Mohamed; Akamine, Nelson; Souza, Rafael Lisboa de

doi:10.1590/s0103-507x2011000300003

Cited by 29 publications

(36 citation statements)

References 86 publications

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“…Despite knowing that the reduction of time spent on the steps of BD protocol is related with viability and preservation of organs and tissues, these professionals need to respect the necessary time for families to experience suffering and mourning [10,11].…”

Section: Discussionmentioning

confidence: 99%

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Time for determining the diagnosis of brain death and its relation to organ donation

Amorim

Mendonça

Freire³

et al. 2017

int arch med

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This study aimed to identify the time needed for confirmation of brain death and its relation to organ donation. Quantitative, descriptive and retrospective study with 175 patients who had diagnosis of brain death completed between january and december 2013. The time from 11 to 20 hours (38.9%) prevailed, with average of 17.91 hours (SD 17.53). There was significant association between the finding of brain death diagnosis in less than 20 hours and the number of donated livers (P = 0.041). We stress the importance of speeding up the diagnosis of brain death as an important step of the donation process, in order to contribute to realization of transplants.

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Section: Discussionmentioning

confidence: 99%

“…Therefore, it is important that within 12 to 24 hours, care with PD be intensified, as well as care to correct organ dysfunction and capture organs for transplantation as soon as possible [10,11].…”

Section: Introductionmentioning

confidence: 99%

Time for determining the diagnosis of brain death and its relation to organ donation

Amorim

Mendonça

Freire³

et al. 2017

int arch med

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“…1,[3][4][5][10][11][12] It is a structured script of non-participant observation, of the checklist type, categorized as Adequate or Inadequate, made up of the following parts: data for characterizing PD; data on the structure of the hospital institutions where the PD were hospitalized; and data on the process of donation of organs and tissues.…”

Section: Methodsmentioning

confidence: 99%

“…This fact occurs because few cities in Brazil have effective conditions to deal with the PD of organs and tissues, due to the volume of patients compared to the low number of professionals and lack of ICU beds, added to the lack of knowledge and of the appropriate valuing of the benefits of donation and transplantation. [11][12] These facts are evidenced by the nearly absolute absence of the systematization of the care for the PD of multiple organs. This is something which exceeds the technical, humanitarian and citizenship sphere of all the actors involved in this patient's maintenance.…”

Section: 15mentioning

confidence: 99%

“…Therefore, the standardization and the speed of these procedures are associated with an increase in the number and quality of the organs transplanted, the reduction in loss of donors, and the increase in post-transplantation survival. 12 Regarding the diagnosis of BD, the consequences which can arise from not undertaking the neurological tests or from the incorrect undertaking of these tests, are concerning, for both the health professionals and the population, given that they influence the running of the process, and give rise to doubts about the concept of BD, as well as erroneous expectations regarding the patient's clinical status.…”

Section: 15mentioning

confidence: 99%

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Facilitating aspects and barriers in the effectiveness of donation of organs and tissues

Freire

Vasconcelos

Melo

et al. 2014

Texto contexto - enferm.

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ABSTRACT:This study aims to ascertain the influence of the structure and process on the effectiveness of donation of organs and tissues. It is an evaluative, longitudinal study, with a quantitative approach, undertaken in six hospitals of Natal-RN, with 65 potential donors. The data collection instrument was a structured script of non-participant observation. The data were analyzed using descriptive statistics and the application of the Chi-squared, Fisher, and Mann Whitney tests. The effectiveness of donation was 27.7%. No significant difference occurred between structure and effectiveness of donation, however, inadequacies were observed in the physical resources (36.9%), material resources (30.8%), organizational structure (29.2%), and human resources (18.5%). In the process, the phases of maintenance (p=0.004), diagnosis of brain death (p=0.032), family interview (p≤0.001) and documentation (p=0.001) presented significant differences with effectiveness. The adequacy of the factors related to the structure and process is associated with the effectiveness of the donation. Improvement of these indices depends on the speed with which the process is conducted, in addition to the adequate structure. DESCRIPTORES:Nursing. Health services evaluation. Effectiveness. Tissue and organ procurement. FACILITADORES E BARREIRAS NA EFETIVIDADE DA DOAÇÃO DE ÓRGÃOS E TECIDOSRESUMO: Verificar a influência da estrutura e processo na efetividade da doação de órgãos e tecidos. Estudo avaliativo, longitudinal, com abordagem quantitativa, desenvolvido em seis hospitais de Natal-RN, com 65 potenciais doadores. O instrumento de coleta de dados constou de roteiro estruturado de observação não participante. Analisaram-se os dados pela estatística descritiva e aplicação dos testes Qui-quadrado, Fisher e Mann Whitney. A efetividade da doação foi 27,7%. Não ocorreu diferença significante entre estrutura e efetividade da doação, porém, observaram-se inadequações nos recursos físicos (36,9%), materiais (30,8%), estrutura organizacional (29,2%) e recursos humanos (18,5%). No processo, as fases de manutenção (p=0,004), diagnóstico de morte encefálica (p=0,032), entrevista familiar (p≤0,001) e documentação (p=0,001) apresentaram diferença significante com a efetividade. A adequação dos fatores relacionados à estrutura e processo está associada à efetividade da doação. A melhora desses índices depende da rapidez com que o processo se conduz, além da estrutura adequada. DESCRITORES: FACILITADORES Y BARRERAS EN LA EFICACIA DE LA DONACIÓN DE ÓRGANOS Y TEJIDOSRESUMEN: Verificar la influencia de la estructura y proceso en la efetividad de la donación de órganos y tejidos. Evaluación, estudio longitudinal con un enfoque cuantitativo, desarrolló en seis hospitales de Natal-RN, con 65 donantes potenciales. El instrumento de recolección consistió en la escritura estructurada de observación no participante. Los datos se analizaron mediante estadística descriptiva y la aplicación de Chi-cuadrado, Fisher y Mann Whitney. La eficacia de la donación fue 27,7%....

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Efficiency of Brazilian public services of kidney transplantation: Benchmarking Brazilian states via data envelopment analysis

Siqueira

Araújo

2018

Health Planning & Management

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an innovative context of application and may be useful for the community of relevant policymakers, academics, and health professionals. KEYWORDS Brazilian health system, data envelopment analysis, efficiency assessment, kidney transplant 1 | INTRODUCTION End-stage renal disease is a serious public health issue in which patient survival depends on renal transplantation or renal replacement therapy, such as dialysis. 1 In the long term, however, kidney transplantation is generally more effective than dialysis in public health system costs and patient quality of life. [2][3][4][5] In Brazil, dialysis is the predominant therapy for the increasing number of cases of end-stage renal disease. 6,7 From 2010 to 2014, the number of patients on dialysis increased from 92 000 to 112 000, with the Brazilian Public Health System (SUS) financing approximately 85% of treatments. 8 Brazil is also 1 of the most active countries in absolute numbers of transplanted organs, with an increasing number of transplants. Its health sector requires substantial public investment, because SUS fully funds more than 90% of transplants performed nationwide. 9Kidney transplantation from deceased donors is the most common mode of solid organ transplantation and requires confirmation of brain death diagnosis and family consent. In 2016, the estimated population needing kidney transplants exceeded the number performed by 45%. 9 Other challenges include the poor infrastructure of public hospitals, crowded intensive care units (ICUs), broken equipment, insufficient health care professionals, and delays in laboratory tests. [9][10][11] In addition, the sector faces an increased demand for SUS services 12-14 and a tight federal health budget. 15 Lastly, the size of Brazil's territory amplifies managerial complexity, with demographic and socioeconomic disparities across states reflected in contrasting availabilities of health resources. 2,16,17 Such a context highlights the importance of assessing how scarce public resources are allocated.In this context, the present study uses data envelopment analysis (DEA) to estimate the technical and scale efficiency (SE) of Brazilian states for kidney transplants performed by SUS from 2013 to 2015. Its general objective is to rank Brazilian states by their technical efficiency scores and identify those operating at an optimal, oversized or undersized scale. Two secondary objectives are to identify states with input idle capacity and to report productivity changes during the period of analysis.Data envelopment analysis is a mathematical method that compares decision making units (DMUs) with similar production processes-units using the same type of inputs to generate analogous outputs, albeit in different amounts. 18,19 The method uses a benchmarking approach that specifies for each inefficient unit an efficient peer as a managerial reference.In contrast to the numerous efficiency studies in other health care fields-mainly using nonparametric methods such as DEA 20-23 -the literature for organ donation and transplant...

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Diretrizes para manutenção de múltiplos órgãos no potencial doador adulto falecido: parte I. Aspectos gerais e suporte hemodinâmico

Cited by 29 publications

References 86 publications

Time for determining the diagnosis of brain death and its relation to organ donation

Time for determining the diagnosis of brain death and its relation to organ donation

Facilitating aspects and barriers in the effectiveness of donation of organs and tissues

Efficiency of Brazilian public services of kidney transplantation: Benchmarking Brazilian states via data envelopment analysis

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