Feasibility of postmortem device acquisition for potential reuse in underserved nations

Area of Science:

• Medical Devices
• Global Health
• Biomedical Engineering

Background:

• Significant healthcare disparities exist between industrialized nations and underserved regions, particularly in pacemaker implantation rates.
• Pacemaker and implantable cardioverter-defibrillator (ICD) utilization is much lower in underserved nations compared to industrialized countries.

Purpose of the Study:

• To assess the feasibility and effectiveness of a program collecting explanted cardiac devices with sufficient battery life from crematories and funeral homes.
• To determine the potential for reusing these devices in underserved nations to address healthcare disparities.

Main Methods:

• A donation program was established, contacting funeral homes and crematories nationwide via mail and online platforms.
• Explanted devices were collected, with adequate battery life defined as ≥75% of original capacity or ≥4 years of estimated longevity.
• Donated devices included pacemakers, implantable cardioverter-defibrillators (ICDs), biventricular ICDs, and biventricular pacemakers.

Main Results:

• A total of 3176 devices were donated, comprising 65% pacemakers, 21% ICDs, 12% biventricular ICDs, and 3% biventricular pacemakers.
• Overall, 21% of donated devices met the criteria for adequate battery life for reutilization.
• Specifically, 30.3% of biventricular ICDs had sufficient battery life for reuse, alongside 17.9% of pacemakers and ICDs.

Conclusions:

• A significant portion of explanted cardiac devices, particularly biventricular ICDs, retain adequate battery life for reuse.
• Donations from funeral homes and crematories represent a viable resource for supplying essential cardiac devices to underserved populations globally.
• This initiative offers a sustainable solution to improve cardiac device accessibility and reduce healthcare disparities in resource-limited settings.