Assessing unrealised potential for organ donation after out-of-hospital cardiac arrest
Abstract Background Organ donation after brain death is the standard practice in many countries. Rates are low globally. This study explores the potential national number of candidates for uncontrolled donations after cardiac death (uDCD) amongst out-of-hospital cardiac arrest (OHCA) patients and th...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-07-01
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| Series: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13049-021-00924-z |
| _version_ | 1818909184733741056 |
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| author | Andrew Fu Wah Ho Timothy Xin Zhong Tan Ejaz Latiff Nur Shahidah Yih Yng Ng Benjamin Sieu-Hon Leong Shir Lynn Lim Pin Pin Pek Han Nee Gan Desmond Renhao Mao Michael Yih Chong Chia Si Oon Cheah Lai Peng Tham Marcus Eng Hock Ong |
| author_facet | Andrew Fu Wah Ho Timothy Xin Zhong Tan Ejaz Latiff Nur Shahidah Yih Yng Ng Benjamin Sieu-Hon Leong Shir Lynn Lim Pin Pin Pek Han Nee Gan Desmond Renhao Mao Michael Yih Chong Chia Si Oon Cheah Lai Peng Tham Marcus Eng Hock Ong |
| author_sort | Andrew Fu Wah Ho |
| collection | DOAJ |
| description | Abstract Background Organ donation after brain death is the standard practice in many countries. Rates are low globally. This study explores the potential national number of candidates for uncontrolled donations after cardiac death (uDCD) amongst out-of-hospital cardiac arrest (OHCA) patients and the influence of extracorporeal cardiopulmonary resuscitation (ECPR) on the candidacy of these potential organ donors using Singapore as a case study. Methods Using Singapore data from the Pan-Asian Resuscitation Outcomes Study, we identified all non-traumatic OHCA cases from 2010 to 2016. Four established criteria for identifying uDCD candidates (Madrid, San Carlos Madrid, Maastricht and Paris) were retrospectively applied onto the population. Within these four groups, a condensed ECPR eligibility criteria was employed and thereafter, an estimated ECPR survival rate was applied, extrapolating for possible neurologically intact survivors had ECPR been administered. Results 12,546 OHCA cases (64.8% male, mean age 65.2 years old) qualified for analysis. The estimated number of OHCA patients who were eligible for uDCD ranged from 4.3 to 19.6%. The final projected percentage of potential uDCD donors readjusted for ECPR survivors was 4.2% (Paris criteria worst-case scenario, n = 532) to 19.4% of all OHCA cases (Maastricht criteria best-case scenario, n = 2428), for an estimated 14.3 to 65.4 uDCD donors per million population per year (pmp/year). Conclusions In Singapore case study, we demonstrated the potential numbers of candidates for uDCD among resuscitated OHCA cases. This sizeable pool of potential donors demonstrates the potential for an uDCD program to expand the organ donor pool. A small proportion of these patients might however survive had they been administered ECPR. Further research into the factors influencing local organ and patient outcomes following uDCD and ECPR is indicated. |
| first_indexed | 2024-12-19T22:22:53Z |
| format | Article |
| id | doaj.art-87121843434743b3aeae777e449737a9 |
| institution | Directory Open Access Journal |
| issn | 1757-7241 |
| language | English |
| last_indexed | 2024-12-19T22:22:53Z |
| publishDate | 2021-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| spelling | doaj.art-87121843434743b3aeae777e449737a92022-12-21T20:03:35ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412021-07-012911810.1186/s13049-021-00924-zAssessing unrealised potential for organ donation after out-of-hospital cardiac arrestAndrew Fu Wah Ho0Timothy Xin Zhong Tan1Ejaz Latiff2Nur Shahidah3Yih Yng Ng4Benjamin Sieu-Hon Leong5Shir Lynn Lim6Pin Pin Pek7Han Nee Gan8Desmond Renhao Mao9Michael Yih Chong Chia10Si Oon Cheah11Lai Peng Tham12Marcus Eng Hock Ong13Department of Emergency Medicine, Singapore General HospitalDepartment of Emergency Medicine, Singapore General HospitalDepartment of Emergency Medicine, Singapore General HospitalDepartment of Emergency Medicine, Singapore General HospitalPre-hospital and Emergency Research Center, Duke-NUS Medical SchoolEmergency Medicine Department, National University HospitalDepartment of Cardiology, National University Heart CentreDepartment of Emergency Medicine, Singapore General HospitalAccident & Emergency, Changi General HospitalDepartment of Acute and Emergency Care, Khoo Teck Puat HospitalEmergency Department, Tan Tock Seng HospitalEmergency Medicine Department, Ng Teng Fong General HospitalChildren’s Emergency, KK Women’s and Children’s HospitalDepartment of Emergency Medicine, Singapore General HospitalAbstract Background Organ donation after brain death is the standard practice in many countries. Rates are low globally. This study explores the potential national number of candidates for uncontrolled donations after cardiac death (uDCD) amongst out-of-hospital cardiac arrest (OHCA) patients and the influence of extracorporeal cardiopulmonary resuscitation (ECPR) on the candidacy of these potential organ donors using Singapore as a case study. Methods Using Singapore data from the Pan-Asian Resuscitation Outcomes Study, we identified all non-traumatic OHCA cases from 2010 to 2016. Four established criteria for identifying uDCD candidates (Madrid, San Carlos Madrid, Maastricht and Paris) were retrospectively applied onto the population. Within these four groups, a condensed ECPR eligibility criteria was employed and thereafter, an estimated ECPR survival rate was applied, extrapolating for possible neurologically intact survivors had ECPR been administered. Results 12,546 OHCA cases (64.8% male, mean age 65.2 years old) qualified for analysis. The estimated number of OHCA patients who were eligible for uDCD ranged from 4.3 to 19.6%. The final projected percentage of potential uDCD donors readjusted for ECPR survivors was 4.2% (Paris criteria worst-case scenario, n = 532) to 19.4% of all OHCA cases (Maastricht criteria best-case scenario, n = 2428), for an estimated 14.3 to 65.4 uDCD donors per million population per year (pmp/year). Conclusions In Singapore case study, we demonstrated the potential numbers of candidates for uDCD among resuscitated OHCA cases. This sizeable pool of potential donors demonstrates the potential for an uDCD program to expand the organ donor pool. A small proportion of these patients might however survive had they been administered ECPR. Further research into the factors influencing local organ and patient outcomes following uDCD and ECPR is indicated.https://doi.org/10.1186/s13049-021-00924-zUncontrolled donations after cardiac deathOrgan donationExtracorporeal cardio-pulmonary resuscitationPan-Asian resuscitation outcomes studyCardiac arrestTransplant |
| spellingShingle | Andrew Fu Wah Ho Timothy Xin Zhong Tan Ejaz Latiff Nur Shahidah Yih Yng Ng Benjamin Sieu-Hon Leong Shir Lynn Lim Pin Pin Pek Han Nee Gan Desmond Renhao Mao Michael Yih Chong Chia Si Oon Cheah Lai Peng Tham Marcus Eng Hock Ong Assessing unrealised potential for organ donation after out-of-hospital cardiac arrest Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Uncontrolled donations after cardiac death Organ donation Extracorporeal cardio-pulmonary resuscitation Pan-Asian resuscitation outcomes study Cardiac arrest Transplant |
| title | Assessing unrealised potential for organ donation after out-of-hospital cardiac arrest |
| title_full | Assessing unrealised potential for organ donation after out-of-hospital cardiac arrest |
| title_fullStr | Assessing unrealised potential for organ donation after out-of-hospital cardiac arrest |
| title_full_unstemmed | Assessing unrealised potential for organ donation after out-of-hospital cardiac arrest |
| title_short | Assessing unrealised potential for organ donation after out-of-hospital cardiac arrest |
| title_sort | assessing unrealised potential for organ donation after out of hospital cardiac arrest |
| topic | Uncontrolled donations after cardiac death Organ donation Extracorporeal cardio-pulmonary resuscitation Pan-Asian resuscitation outcomes study Cardiac arrest Transplant |
| url | https://doi.org/10.1186/s13049-021-00924-z |
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