Organ donation after extracorporeal cardiopulmonary resuscitation for refractory out-of-hospital cardiac arrest in a...

Area of Science:

• Cardiology
• Transplantation Medicine
• Critical Care

Background:

• Extracorporeal cardiopulmonary resuscitation (ECPR) is utilized for refractory out-of-hospital cardiac arrest (OHCA).
• ECPR patients frequently become potential organ donors, expanding the donor pool.
• The impact of organ donation on OHCA patients treated with ECPR requires detailed analysis.

Purpose of the Study:

• To investigate the rate and impact of organ donation in OHCA patients undergoing ECPR.
• To determine the number of individuals benefiting from ECPR, including survivors and organ recipients.

Main Methods:

• Analysis of refractory OHCA patients treated with ECPR from January 2013 to November 2022.
• Primary outcome: organ donation rate. Secondary outcomes: organs harvested, ECPR benefit (survival with favorable neurological outcome or organ donation), and total beneficiaries.
• Data collected at San Raffaele Hospital, Milan, Italy.

Main Results:

• Of 307 patients, 58 (19%) donated at least one solid organ, yielding 167 organs.
• 196 individuals potentially benefited: 29 survivors with favorable neurological outcome and 167 organ recipients.
• Organ donation rates were lower in patients with shorter low-flow times (<60 min) and initial shockable rhythms.

Conclusions:

• Organ donation after ECPR failure in OHCA patients significantly benefits transplant recipients.
• ECPR enhances overall patient benefit through both direct survival and indirect organ provision.
• ECPR selection criteria may influence the number of potential organ donors.