Please use this identifier to cite or link to this item: https://doi.org/10.1186/s13049-021-00924-z
Title: Assessing unrealised potential for organ donation after out-of-hospital cardiac arrest
Authors: Ho, Andrew Fu Wah 
Tan, Timothy Xin Zhong
Latiff, Ejaz
Shahidah, Nur 
Ng, Yih Yng 
Leong, Benjamin Sieu-Hon 
Lim, Shir Lynn 
Pek, Pin Pin 
Gan, Han Nee 
Mao, Desmond Renhao 
Chia, Michael Yih Chong 
Cheah, Si Oon 
Tham, Lai Peng 
Ong, Marcus Eng Hock 
Keywords: Science & Technology
Life Sciences & Biomedicine
Emergency Medicine
Uncontrolled donations after cardiac death
Organ donation
Extracorporeal cardio-pulmonary resuscitation
Pan-Asian resuscitation outcomes study
Cardiac arrest
Transplant
ASIAN RESUSCITATION OUTCOMES
CIRCULATORY DEATH
CARDIOPULMONARY-RESUSCITATION
KIDNEY-TRANSPLANTATION
UNCONTROLLED DONATION
DONORS
HEART
SINGAPORE
Issue Date: 28-Jul-2021
Publisher: BMC
Citation: Ho, Andrew Fu Wah, Tan, Timothy Xin Zhong, Latiff, Ejaz, Shahidah, Nur, Ng, Yih Yng, Leong, Benjamin Sieu-Hon, Lim, Shir Lynn, Pek, Pin Pin, Gan, Han Nee, Mao, Desmond Renhao, Chia, Michael Yih Chong, Cheah, Si Oon, Tham, Lai Peng, Ong, Marcus Eng Hock (2021-07-28). Assessing unrealised potential for organ donation after out-of-hospital cardiac arrest. SCANDINAVIAN JOURNAL OF TRAUMA RESUSCITATION & EMERGENCY MEDICINE 29 (1). ScholarBank@NUS Repository. https://doi.org/10.1186/s13049-021-00924-z
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.
Source Title: SCANDINAVIAN JOURNAL OF TRAUMA RESUSCITATION & EMERGENCY MEDICINE
URI: https://scholarbank.nus.edu.sg/handle/10635/228742
ISSN: 17577241
DOI: 10.1186/s13049-021-00924-z
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