Andrés Belmonte, Amado

González, Esther

Gutiérrez, Eduardo

Mateos Rodríguez, Alonso

Polanco, Natalia

Rubio Chacón, C.

Villar Arias, Alicia

English

DDFV

USE OF THE CAPNOMETRY AS A RENAL GRAFT EVOLUTION PREDICTOR IN UNCONTROLLED CARDIAC ARRESTDEATH DONORSAlicia Villar-Arias1, Alonso Mateos-Rodríguez2, Carlos Rubio-Chacón1, Esther González3, Natalia Polanco3, Eduardo Gutiérrez3, Amado Andrés-Belmonte31Emergency Department SUMMA 112, Community of Madrid Health Department, Madrid, Spain; 2Community of Madrid Regional Transplants Office, Community of Madrid Health Department, Madrid, Spain; 3Nephrology Department, Doce de Octubre University Hospital, Madrid, SpainIntroduction: The modified Maastricht classification identifiestype IIa donors as uncontrolled donors after cardiac death andincludes those patients who do not recover spontaneouscirculation after advanced life support. Capnometry or end-tidalcarbon dioxide (Et-CO2) is clearly related to ventilation and tissueperfusion.Objective: To correlate the levels of capnometry duringresuscitation and preservation process with the viability andevolution of renal grafts. Therefore, the EtCO2 may be aparameter to be assessed in the suitability of grafts from uDCD.Methodology: Retrospective descriptive study from 2013 to 2017 based on the data collection from a series of potential donorstransferred by SUMMA112 to Doce de Octubre University Hospital and the post-transplant evolution.Results:Grafted kidney(n=30)No graftedkidney(n=7) P-valueAge (years) 45,83 40,43 p=0,051Gender (male/female) 26/4 7/0 p=0,306Initial capnometry (mmHg) 26,6 21,57 p=0,471Transfer capnometry (mmHg) 22,8 17,35 p=0,016Smoker (%) 40 42,85 p=0,890Time Cardiac Arrest- Advanced lifesupport (min) 12,6 9,43 p=0,119Normothermic perfusion (hours) 5,61 5,41 p=0,487Et-CO2 (SD) p ValueGraftedkidney22,80 (±9,412)p=0,016No graftedkidney17,35 (±10,323)No patient has presented an acute graft rejectionGraft survival was 100%No death occurred during the study periodConclusions:• A statistically significant association has been found between the capnometry values and the validity of the renal grafts• It seems that there is an association between lower capnometry values with a delay in renal function of graft, althoughwithout statistical significance. This may be influenced by the sample size.• A prospective study that analyzes the validity of the capnometry as a predictor of the organs suitability in the uDCD in moredepth is needed.0204060Initial Transfer552926,820,2YESNOInitialEt-CO2TransferEt-CO2Primaryrenal failureYES (1) 55 29NO (54) 26,8 20,2p-value 0,1 0,8051015202530Initial Transfer27,41924,626,3YESNOInitialEt-CO2TransferEt-CO2Renal functiondelayYES (45) 27,4 19NO (10) 24,6 26,3p-value 0,9 0,2Primary renal failureRenal function delayAuthors declare that there are no relevant financial disclosures , so they  have nothing to disclose

Use of the capnometry as a renal graft evolution predictor in uncontrolled cardiac arrest death donors.

http://ddfv.ufv.es/bitstream/10641/1830/1/USO%20DE%20LA%20CAPNOGRAFIA%20TTS.pdf

Use of the capnometry as a renal graft evolution predictor in uncontrolled cardiac arrest death donors.

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