Viveka K. Nainani MBBS BMedSci , Byron Arcia Data analyst , David Pilcher MBBS MRCP (UK) FCICM FRACP , Joshua Ihle FCICM , Arne Diehl FCICM , Samuel Radford FCICM FRACP , Rohit D'Costa FRACP FCICM MBioEth , Vinodh B. Nanjayya FCICM
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引用次数: 0
Abstract
Objective
To describe the characteristics and the trend of organ donation from donors on extracorporeal membrane oxygenation (ECMO) or ventricular assist devices (LVAD).
Design
Retrospective, observational, cohort study from June 2014 to June 2021.
Setting
A multicentre study in Victoria, Australia, using DonateLife Victoria databases.
Participants
All patients on ECMO/LVAD were referred to DonateLife for organ donation.
Main outcome measures
Number, proportion, time trend and type of organ donations from the patients on ECMO/LVAD.
Results
There were 78 donor referrals [mean (SD) age 42 (18.8) yrs, 56 (72 %) males] from patients on Veno-arterial ECMO (73 %), Veno-venous ECMO (16 %) or LVAD (6.4 %), of which 37 (47 %) donated. The annual median (IQR) referral and donation rates were 8 (5–10)/year and 4 (3–7)/year, respectively. Medical contraindications were the main reason for declining organ donation [21(51 %)]. Donation after neurological determination of death (DNDD) occurred in 20 (54 %), and donation after circulatory determination of death (DCDD) in 17 (46 %). The median (IQR) time from admission to referral for donation was longer in DCDD compared to DNDD patients. Eighty-three organs were retrieved from 37 donors (2.24 organs per donor), out of which 68 organs (82 %) were transplanted in 68 recipients. Kidneys were the most common organs retrieved (73 %) and transplanted (79 %).
Conclusion
Organ donation on ECMO/LVAD occurs only in half of the referred patients. Further studies are needed to ascertain the barriers to donations and to assess the long-term outcomes of these donations.
期刊介绍:
ritical Care and Resuscitation (CC&R) is the official scientific journal of the College of Intensive Care Medicine (CICM). The Journal is a quarterly publication (ISSN 1441-2772) with original articles of scientific and clinical interest in the specialities of Critical Care, Intensive Care, Anaesthesia, Emergency Medicine and related disciplines.
The Journal is received by all Fellows and trainees, along with an increasing number of subscribers from around the world.
The CC&R Journal currently has an impact factor of 3.3, placing it in 8th position in world critical care journals and in first position in the world outside the USA and Europe.