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Pre-clinical Model of Cardiac Donation after Circulatory Death
06:26

Pre-clinical Model of Cardiac Donation after Circulatory Death

Published on: August 2, 2019

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Uncontrolled donation programs after out-of-hospital cardiac arrest. An estimation of potential donors

Jose Maria Navalpotro-Pascual1, Alfredo Echarri-Sucunza2, Alonso Mateos-Rodríguez3

  • 1SUMMA 112, Madrid, Spain.

Resuscitation
|November 30, 2017
PubMed
Abstract

Insights

Many potential organ donors are missed in Spain due to underused uncontrolled donation after cardiac death (uDCD) programs. This study identified 571 potential deceased organ donors from out-of-hospital cardiac arrest (OHCA) cases, highlighting a gap in donation practices.

Area of Science:

  • Emergency Medicine
  • Transplantation Medicine
  • Public Health

Background:

  • Out-of-hospital cardiac arrest (OHCA) represents a significant source of potential deceased organ donors.
  • Spain has high organ transplantation rates, but the utilization of donors from OHCA is not well-defined.
  • Current clinical practices may miss opportunities for organ donation from OHCA patients.

Purpose of the Study:

  • To quantify the number of potential deceased organ donors from OHCA cases attended by emergency medical services in Spain.
  • To assess the feasibility of uncontrolled donation after cardiac death (uDCD) programs in this population.

Main Methods:

  • Analysis of data from the Spanish OHCA Registry (OHSCAR) for deceased OHCA patients between October 2013 and October 2014.
  • Inclusion criteria: age 16-60, witnessed OHCA, no return of spontaneous circulation (ROSC), and time from OHCA to cardiopulmonary resuscitation (CPR) initiation <15 minutes.
  • Comparison of actual donor rates between provinces with and without established uDCD programs.

Main Results:

  • Out of 8789 OHCA cases, 571 met all criteria to be considered potential donors.
  • Only 141 of these potential donors were actually included in uDCD programs.
  • Provinces with uDCD programs had significantly higher donor utilization rates (43.8%) compared to those without (0%).

Conclusions:

  • A substantial number of potential organ donors are missed in current clinical practice following OHCA.
  • Uncontrolled donation after cardiac death (uDCD) programs are underutilized in Spain, despite the country's high transplantation rates.
  • There is a need to expand and optimize uDCD programs to improve organ donor yield from OHCA events.
Keywords:
Emergency medical servicesOut-of-hospital cardiac arrestPhysician on boardUncontrolled donation after cardiac death

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