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Updated: May 5, 2026
Pre-clinical Model of Cardiac Donation after Circulatory Death
Published on: August 2, 2019
Controlled donation after circulatory death in post-cardiac arrest patients: Estimates from a large registry
Marie Renaudier1, Yannick Binois2, Florence Dumas3
1Paris Cardiovascular Research Centre (PARCC), INSERM Unit 970, Paris, France; Paris Sudden Death Expertise Centre, Paris, France; Université Paris Cité, Paris, France; Intensive Care Unit, Cochin-Hotel-Dieu Hospital, AP-HP, Paris, France.
Insights
Controlled donation after circulatory death (cDCD) following out-of-hospital cardiac arrest (OHCA) offers a significant, underutilized organ donor pool in France. This study estimates that 515 potential cDCD donors could be identified annually, highlighting a crucial opportunity for transplantation.
Area of Science:
- Transplantation Medicine
- Critical Care Medicine
- Public Health
Background:
- Controlled donation after circulatory death (cDCD) is a vital but underutilized organ source, particularly for patients with post-anoxic brain injury.
- Out-of-hospital cardiac arrest (OHCA) survivors who do not recover neurological function represent a potential donor population.
Purpose of the Study:
- To assess the number of potential cDCD donors following OHCA in the Paris region.
- To extrapolate these findings to the entire French population to estimate national organ donation potential.
Main Methods:
- Prospective inclusion of adult OHCA patients with return of spontaneous circulation (ROSC) admitted to intensive care units (ICUs) in the Paris area.
- Identification of patients who died after withdrawal of life-sustaining treatments (WLST) due to post-anoxic brain injury.
- Calculation and extrapolation of potential cDCD donor numbers based on French criteria.
Main Results:
- Between 2011-2018, 1034 patients died in ICU after WLST due to post-anoxic brain injury following OHCA.
- 41% (421 patients) met criteria for potential cDCD donation in the Paris region (55 per year).
- Extrapolated nationally, an estimated 515 potential cDCD donors per year (1.18 per 100,000 inhabitants) could be identified in France.
Conclusions:
- Controlled donation after circulatory death following cardiac arrest presents a substantial, largely untapped donor pool in France.
- Increasing the utilization of cDCD donors could significantly enhance organ availability for transplantation.
Background:
Controlled donation after circulatory death (cDCD) in post-anoxic brain injury is a valuable source of organs that is still underused in some countries. We assessed the number of potential cDCD donors after out-of-hospital cardiac arrest (OHCA) in Paris and its suburbs and extrapolated the results to the French population.
Methods:
Using the large regional registry of the Great Paris area, we prospectively included all consecutive adults with OHCA with a stable return of spontaneous circulation (ROSC) who ultimately died in the intensive care unit (ICU) after withdrawal of life-sustaining treatments (WLST) due to post anoxic brain injury. The primary endpoint was potential for organ donation by cDCD in this population. The number of potential cDCD donors was calculated and extrapolated to the entire French population.
Results:
Between 2011 and 2018, 4638 patients with stable ROSC were admitted to ICUs after OHCA, and 3170 died in ICU, of which 1034 died after WLST due to post-anoxic brain injury. When considering French criteria, 421/1034 patients (41%) would have been potential cDCD donors (55 patients per year in a 4.67 million population). After standardization for age and sex, the potential for cDCD was 515 (95% CI 471-560) patients per year in France corresponding to an annual incidence of 1.18 per 100 000 inhabitants per year.
Conclusions:
Organ donation by cDCD after cardiac arrest could provide a large pool of donors in France.
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