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Updated: Mar 15, 2026
Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
Nonaccidental Out-of-Hospital Cardiac Arrest in an Urban Area as a Potential Source of Uncontrolled Organ Donors
Krzysztof Pabisiak1, Arkadiusz Krejczy2, Grażyna Dutkiewicz1
1Department of Nephrology Transplantation and Internal Medicine, Pomeranian Medical University, Szczecin, Poland.
Insights
Implementing uncontrolled donation after circulatory death (uDCD) in Poland could increase the organ donor pool by 6 cases annually. This initiative offers a significant 22% rise in transplantable organs, vital for saving lives.
Area of Science:
- Transplantation Medicine
- Emergency Medical Services
- Public Health Policy
Background:
- Donation after cardiac death (DCD) can increase organ availability by up to 30%.
- Maastricht category 3 (M3) is common in DCD programs; Poland primarily uses Maastricht category 2 (M2).
- Estimating the donor pool is crucial for establishing uncontrolled donation after circulatory death (uDCD) programs.
Purpose of the Study:
- To estimate the potential donor pool for uncontrolled donation after circulatory death (uDCD) in Szczecin, Poland.
- To assess the feasibility and impact of introducing a permanent uDCD program.
- To evaluate the potential increase in organ recovery.
Main Methods:
- Retrospective cohort study of out-of-hospital cardiac arrests (OHCA) reported to Emergency Medical Services (EMS) over 12 months.
- Inclusion criteria: age 18-60, known identity, no significant trauma, no wasting diseases, weekday interventions (8 am-3 pm).
- Stratification of potential, eligible, qualified, and actual donor pools.
Main Results:
- 118 EMS interventions for sudden cardiac arrest were recorded.
- Potential, eligible, qualified, and actual donor pools comprised 27 (30.3%), 24 (26.4%), 7 (7.3%), and 6 (6.7%) cases, respectively.
- A 12% nationwide average lack of authorization for donation was considered.
Conclusions:
- A permanent uDCD program could add 6 donors annually in Szczecin.
- This increase is comparable to establishing a new regional hospital reporting center.
- The number of transplantable organs could rise by 22% per year.
Abstract:
BACKGROUND Donation after cardiac death offers the possibility of increasing the pool of organs for transplantation by up to 30%. Maastricht category type 3 (M3) dominates in most countries with active DCD programs. During preparations to introduce a permanent program for uncontrolled donation after circulatory death in Szczecin, Poland, the donor pool has been estimated. In Poland, Maastricht category type 2 (M2) is considered a basic source for organ recovery. MATERIAL AND METHODS This was a retrospective cohort study of out-of-hospital cardiac arrests (OHCA) reported to local Emergency Medical Services (EMS) between 1 December 2014 and 30 November 2015. The following inclusion criteria were used in the analysis: demographic (age 18-60 years, known identity), clinical (no chest or abdominal injury, no cachexia as an equivalent of wasting diseases), and organizational (weekdays from 8:00 am to 3:00 pm). RESULTS During 12-month period, 118 EMS interventions were recorded in response to sudden cardiac arrest. The stratification process mentioned above used criteria to establish potential, eligible, qualified, and actual donor pools (27 (30.3%), 24 (26.4%), 7 (7.3%), and 6 (6.7%), respectively). To establish a "virtual" actual number of uDCD, the nationwide average level of lack of authorization for donation was 12%. CONCLUSIONS Activation of a permanent program of organ recovery from uDCD would increase the donor pool by 6 cases. Compared to the number of brain-dead donors referred from regional hospitals, this increase would be equivalent to the formation of a new reporting center. The number of transplantable organs could increase by 22% per year.
