Development of a multidisciplinary protocol for thoracic organ donation process
Luiz Gustavo Dias da Cruz1, Prof. Dr. Tereza Cristina Felippe Guimarães1.
1Divisão de Ensino e Pesquisa, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
Introduction: In Brazil, transplants of solid thoracic organs are less frequent than those of solid organs (kidney and liver, for example). With the increase in survival and the quality of life of transplant patients, the indication for transplants and the demand for this therapy have grown significantly in the last two decades. However, although the demand and effectiveness of transplants has increased, the lack of organs remains one of the greatest barriers for transplant teams in all countries, as the demand is increasing in relation to the realization of donations, thus increasing the lists waiting. Even with the existence of some protocols for the maintenance of the potential donor, we can observe that the use of organs for transplantation remains reduced in Brazil.
Objectives: To develop a systematic multidisciplinary protocol aimed at the process of donating thoracic organs to the Intra-Hospital Transplant Commission, based on a bibliographic survey of a synthesis of evidence in the specialized scientific literature to assist in the construction of the care protocol.
Methods: Systematic review of the specialized literature to develop a systematic protocol of specific care for chest uptake; construction of a questionnaire based on the scientific evidence researched in the specialized literature, and subsequent technical review of such evidence, carried out by a committee of experts.
Results: Following the selection criteria available in the systematic literature review, twelve (12) studies for the extraction of scientific evidence were listed, all available in English. In all, twenty-one (21) scientific evidences were collected from their total sum. The expert committee was composed of seventeen (17) members, who had access to the questionnaire. The categorization of respondent subjects was as follows: nine (9) doctors, seven (7) nurses and one (1) physiotherapist. The set of evidence shown here can contribute to improving the outcome, in providing reliable scientific information and in a broader field of engagement of the multidisciplinary team in this process. Three (3) domains were designed, and from these the protocol presented here was built.
Conclusion: The study developed the domains of the thoracic organ donation process, and proposed actions that can be carried out by the multidisciplinary health team in the various scenarios existing in Brazilian cities. The review used as a scientific basis systematized new scientific evidence for the academic and / or care community. Finally, this Multidisciplinary Protocol for the Process of Donating Thoracic Organs is the beginning of a trail of knowledge that aims to reduce waiting time and bring more quality of life to the 277 heart transplant candidates and the 195 lung transplant candidates who exist in the country in 2021.
Keywords: organ donation; evidence-based practice; systematic review.
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