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The feasibility of organ salvage from non-heart-beating trauma donors
1Department of Surgery, University of California, Davis, USA.
Background:
Blunt trauma patients without vital signs on admission are potential non-heart-beating donors.
Objective:
To review the feasibility of postmortem visceral perfusion and organ donation in blunt trauma patients without vital signs.
Design:
A retrospective case series of blunt trauma victims who were declared dead in the emergency department.
Setting:
A level I trauma center.
Main Outcome Measures:
Factors potentially precluding donation and potential donor yield.
Results:
The mean trauma-to-death interval was 71 minutes (< 60 minutes in 57% of the cases). Injuries likely to interfere with in situ perfusion were present in 41% of the cases. The tissue donation consent rate was 45%. Assuming a similar organ donation consent rate, the potential donor yield was 9% after excluding victims who were younger than 60 years of age, warm ischemia times that were less than 60 minutes, and patients who had injuries precluding perfusion.
Conclusions:
The potential organ yield from non-heart-beating, blunt trauma victims is low, which highlights the ethical and legal problems of this approach.