• Despoina Koukousaki, Marinos Kosmopoulos, John Mallow, Pierre S Sebastian, Christopher Monti, Alejandra Gutierrez, Andrea Elliott, Rajat Kalra, Sergey Gurevich, Tamas Alexy, Charles Bruen, Varvara Kirchner, Jason A Bartos, and Demetris Yannopoulos.
• University of Minnesota Medical School, Department of Medicine, Division of Cardiology, Center for Resuscitation Medicine, MN, USA.
• Resuscitation. 2024 Oct 1; 203: 110391110391.

AimsThis study explores the evolution of organ donation from patients treated with extracorporeal-cardiopulmonary-resuscitation (ECPR) for refractory out-of-hospital-cardiac-arrest (OHCA) and evaluates the public health benefits of a mature ECPR program.MethodsThis retrospective, single-center study included OHCA patients (2016-2023) who had mostly initial shockable rhythms and were treated with ECPR. Organ donation rates from non-survivors through these years were analyzed. The public health benefit of ECPR was determined by the ratio of the sum of survivors with Cerebral Performance Category 1-2 and non-survivors who donated at least 1 solid organ, to the total ECPR patients. Temporal trends were analyzed yearly using linear regression.ResultsOut of 419 ECPR patients presenting with refractory OHCA over the study period, 116 survived neurologically intact (27.7%). Among non-survivors (n = 303), families of 41 (13.5%) consented to organ donation (median age 51 years, 75.6% male) and organs from 38 patients were harvested, leading to 74 organ transplants to 73 recipients. The transplanted organs included 43 kidneys (58.1%), 27 livers (36.5%), 3 lungs (4%), and 1 heart (1.4%), averaging 2.4 ± 0.9 accepted organs/donor. The number of organ donors and successful transplants correlated positively with the years since the ECPR program's initiation (ptrend = 0.009, ptrend = 0.01). Overall, 189 patients (116 survivors, 73 organ recipients) benefited from ECPR, achieving organ-failure-free survival. The cumulative public health benefit of ECPR, considering the 116 survivors and 38 donors was 36.8%.ConclusionThe public health benefits of an established ECPR program extend beyond individual ECPR patient survival, forming a new, previously under-recognized source of transplant donors.Copyright © 2024 Elsevier B.V. All rights reserved.

27 keywords...

hide…