Non-heart-beating donors from the streets: an increasing donor pool source

Area of Science:

• Transplantation Medicine
• Organ Donation
• Public Health

Background:

• Non-heart-beating donors are increasingly vital for organ procurement, particularly kidneys.
• Hospitals are exploring organs from out-of-hospital deaths, including those occurring in public spaces.
• A hospital-based policy was implemented to successfully procure organs and tissues from deceased individuals found in the streets.

Purpose of the Study:

• To evaluate the feasibility and outcomes of organ and tissue donation from out-of-hospital deaths.
• To establish strict selection criteria for identifying suitable non-heart-beating donors from this population.
• To assess the viability and transplant success rates of organs procured from these donors.

Main Methods:

• Potential donors were identified as individuals dying out-of-hospital, under 50 years old, with minimal asystolia (<15 min without CPR), and no contraindications.
• Following death certification by an emergency room physician, cadavers were transferred to the operating room.
• Cardiopulmonary bypass was initiated for organ preservation during legal donation procedures.

Main Results:

• 111 cadavers were considered, with 53 confirmed as actual non-heart-beating donors.
• Average time from death to hospital arrival was 68 minutes; cardiopulmonary bypass began 111 minutes post-cardiac arrest.
• Procured organs included 105 kidneys, 12 livers, 84 corneas, 31 pancreata, and 49 long bones. 72 kidneys were transplanted with an 83% survival rate at 36 months.

Conclusions:

• Organ procurement from deceased individuals found in the streets is viable.
• Strict selection criteria are crucial for successful organ and tissue retrieval from non-heart-beating donors.
• This approach expands the donor pool and offers life-saving transplant opportunities.