title: Intensive care medicine and organ donation: exploring the last frontiers?
abstract: The main, universal problem for transplantation is organ scarcity. The gap between offer and demand grows wider every year and causes many patients in waiting list to die. In Spain, 90% of transplants are done with organs taken from patients deceased in brain death but this has a limited potential. In order to diminish organ shortage, alternative strategies such as donations from living donors, expanded criteria donors or donation after circulatory death, have been developed. Nevertheless, these types of donors also have their limitations and so are not able to satisfy current organ demand. It is necessary to reduce family denial and to raise donation in brain death thus generalizing, among other strategies, non-therapeutic elective ventilation. As intensive care doctors, cornerstone to the national donation programme, we must consolidate our commitment with society and organ transplantation. We must contribute with the values proper to our specialization and try to reach self-sufficiency by rising organ obtainment.
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, España; Unidad de Coordinación de Trasplantes y Medicina Regenerativa, Hospital Universitario Central de Asturias, Oviedo, España. Electronic address: dolores.escudero@sespa.princast.es.
authors.forename: D
authors.initials: D
authors.lastname: Escudero
authors.affiliation: Unidad de Coordinación de Trasplantes y Medicina Regenerativa, Hospital Universitario Central de Asturias, Oviedo, España.
authors.forename: J
authors.initials: J
authors.lastname: Otero
mesh_terms: D024362:Advance Directive Adherence; D001294:Attitude to Health; D001926:Brain Death; D001930:Brain Injuries / Q000401:mortality; D002423:Cause of Death; D003422:Critical Care / Q000941:ethics / Q000639:trends*; D003643:Death; D005060:Europe; D005544:Forecasting; D006323:Heart Arrest; D006748:Hospital Departments / Q000600:supply & distribution; D006801:Humans; D009493:Neurosurgery; D045808:Refusal to Participate; D012121:Respiration, Artificial / Q000941:ethics; D013727:Terminal Care / Q000331:legislation & jurisprudence; D020458:Third-Party Consent; D014019:Tissue Donors / Q000331:legislation & jurisprudence / Q000600:supply & distribution*; D020858:Tissue and Organ Harvesting / Q000941:ethics / Q000331:legislation & jurisprudence; D009927:Tissue and Organ Procurement / Q000941:ethics / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data / Q000639:trends*; D014481:United States
keywords: Brain death; Donación de órganos; Donación en asistolia; Muerte encefálica; Non heart beating donation; Non-terapheutic elective ventilation; Organ donation; Transplantation; Trasplantes; Ventilación electiva-no terapéutica