Donación de órganos en asistolia controlada y cuidados del final de vida: Una nueva realidad ética en cuidado intensivo

Abstract

Organ donation in brain or neurological death is an accepted scientific and ethical procedure, however, the demand for transplants exceeds the supply of organs, having to resort to other forms of donation. To the so-called non-heart-beating donors described in the literature as uncontrolled asystolic donors and controlled asystolic donors, detected inside and outside the intensive care units. This new way of obtaining organs is becoming an increasingly accepted method in the world, due to the favorable results obtained.

The intensive care physician in end-of-life care requires knowledge of this new way of detecting donors in patients in imminent death with terminal catastrophic illness category Maastricht III. Where the vision of informed, subrogated consent, advance directives, autonomy, respect for dignity, rights, controlled withdrawal of life support, terminal extubation and circulatory arrest, must be taken into account before the decision of the patient or family member in their will to donate. To understand donors in controlled asystole, end-of-life care, and ethical issues in intensive care, a systematic review was performed using the ask Medline search tool in Medline/PubMed and three PICO questions related to the search were answered. Concepts of the terms used in end of life and DAC and ethical aspects and DAC were established according to the references.

The objective of this review was to know what is related to organ donation in controlled asystole, end-of-life care and its ethical aspects in intensive care.