First organ donation in controlled asystole

The General University Hospital of Ciudad Real, dependent on the Castilla-La Mancha Health Service (SESCAM), has made the first organ donation in controlled asystole.

Asystole donation is the donation of organs and tissues that come from a donor who is diagnosed as dead after confirmation of the irreversible cessation of cardiorespiratory functions (absence of heartbeat and spontaneous breathing).

Castilla-La Mancha approved in 2019 the Autonomous Protocol for Donation in Controlled Asystole to try to incorporate all hospitals with organ extraction capacity. This project is a challenge that responds to the need to reach the maximum possible donors.

In this sense, the medical transplant coordinator, Dr. Luis Yuste, thanked “the generosity of the donors and, especially their families, without whom we would not have been able to start this project” and has also valued “the fundamental collaboration of all the teams, both hospital and extra-hospital, that have involved more than 30 people in the last donation that has taken place”.

“We always talk about the solidarity of citizens when we talk about organ donation, but for that solidarity to become a transplant, well-trained professionals and the institutional support of the administrations are also needed to provide them with the necessary tools”, stressed the Dr. Yuste.

In 2022, the Ciudad Real Integrated Care Management registered eleven multi-organ donations, of which thirty-three organs and twelve corneas were obtained, all of them from brain-dead donors. This asystole donation project will make it possible to accommodate other types of patients who want to be donors and who until now could not see their desire to be fulfilled.

ECMO Donation Program

Promoting donation in controlled asystole in SESCAM hospitals is one of the strategies that the Regional Transplant Coordination is betting on, in order to increase the number of potential donors.

For this, the perfusion systems known as ECMO, acronyms in English that call the extracorporeal membrane oxygenation device, are incorporated. With this technology, adequate perfusion and maintenance of the organs to be transplanted during the surgical extraction process is achieved.

Currently, ECMO is the most advantageous preservation technique at the time of abdominal organ removal, in terms of better immediate function of the transplanted organ, fewer post-transplant complications, shorter hospital stay, and better graft survival.

For its implementation, SESCAM and the Regional Coordination have created a mobile-ECMO project that, on this first occasion, has had the advice of the Hospital Coordination of Transplants of the Hospital de Toledo for its initial launch in the Ciudad Real Hospital.

In the same way, the Management of Ciudad Real, accredited for the extraction of organs, has provided all the necessary human and technical equipment to carry out this new therapy using an extracorporeal membrane oxygenator.

It is necessary to highlight the participation of the entire hospital as a whole and especially the Intensive Medicine, Urology, Ophthalmology, Radiology, Laboratory and Clinical Analysis, Nursing, Operating Room, Blood Bank, assistants and orderlies services, which have made it possible to achieve this new challenge.

Who can be a donor?

Donation is a health right of citizens and families of donors, as well as an act with its own indisputable ethical values. Whenever it is possible to donate, families should be able to exercise this right.

It must be remembered that, a priori and regardless of age, anyone who decides that they want their organs to save or improve the lives of other people after their death can be a donor. This will must be transmitted to their closest relatives so that it is known and can be transmitted to the health services responsible for carrying out that wish.

In the case of minors, the consent of the parents or guardians is necessary to process the donor card.