ANÁLISE EPIDEMIOLÓGICA DO PROCESSO DE AVALIAÇÃO DE POTENCIAIS A EFETIVOS DOADORES DE ÓRGÃOS E TECIDOS

Abstract

Chronic and degenerative non-communicable diseases can culminate in complex clinical conditions and progress to failure of the affected organ. When this occurs, only replacement therapy through organ transplantation constitutes the possibility of increasing survival and quality of life. In this context, to meet a large demand it is necessary to promote an improvement in the political and technical process, from the beginning of the identification of potential donors to the completion of the transplant procedure. Thus, this research aims to analyze the clinical, epidemiological aspects and outcomes of the process of evaluating potential and effective organ and tissue donors. This is a research with a single-group prospective cohort design. The research sites were the three institutions that serve the single health system and are state and regional references. Data collection took place over two years, from June 2021 to May 2023, carried out using secondary data from potential donors (PD), with the help of a data collection instrument built based on theoretical and normative references about the topic. The calculated sample was 124 cases. 282 notifications of opening the BD protocol were evaluated, after applying the inclusion and exclusion criteria cases, with 127 PD that made up the final sample; with a predominance of males, average age of 50.58 (±14.0) years and primary education level. Cardiovascular comorbidities predominated, as well as causes of brain death (BD) related to cerebral circulation and bleeding. Authorization for donation occurred in 28.3% of cases and in more than 45% the children were responsible. The non-authorization was mainly due to the family's desire to keep the body intact. 76 organs were transplanted and the estimated loss of possible transplants was 88.9%. The age group of 60 years or more was associated with the highest number of donors (p=0.024). The chance of patients residing in the capital to donate increased by 2.25 times when compared to those living in the state countryside. Likewise, the chance of success in the family interview increased by 3.15 times (CI=1.11-9.0) when carried out on the day of the BD, when compared to those carried out 24 hours after confirmation. Thw chance of individuals becoming donors also increased by 3.41 (IC=1.29-9.03) times when the interview with the family was carried out in the same period. After BD, support from non-donors was withdrawn more than two hours after confirmation and death was registered based on the time of BD in only 38.7% of cases. This research generally found young, male adults with a lower level of education in the context of BD. Furthermore, elderly individuals (> 60 years old) and those residing in the capital were associated with the highest number of donors. Likewise, approaching the family on the same day as the BD allowed for greater chances of acceptance and donations.