2013 - ISODP 2013 Congress


Oral Presentation 3 on DCD Programs 1

41.3 - Donation after cardiac death category II in the emergency department. What is the impact?

Presenter: Danielle, Nijkamp, Groningen, Netherlands
Authors: Danielle Nijkamp, Marije Smit, Marc Seelen, Bas Bens, Christina Krikke, Michiel Erasmus


Donation after cardiac death category II in the emergency department. What is the impact?

Danielle Nijkamp1, Marije Smit2, Marc Seelen3, Bas Bens4, Christina Krikke5, Michiel Erasmus6

1Surgery, Division of Organ Donation, University Medical Center Groningen, Groningen, Netherlands, 2Critical Care Medicine, University Medical Center Groningen, Groningen, Netherlands, 3Nephrology, University Medical Center Groningen, Groningen, Netherlands, 4Emergency Room, University Medical Center Groningen, Groningen, Netherlands, 5Surgery, Division of Organ Donation and Transplantation, University Medical Center Groningen, Groningen, Netherlands, 6Cardiothoracic Surgery and Lung Transplantation, University Medical Center Groningen, Groningen, Netherlands

Background

Donation after cardiac death category II (DCD II) in patients after unsuccessful cardiac resuscitation could expand the existing donor pool for lung and kidney transplantation.

Aim

To assess the size of the potential DCD II donor pool for lung and kidney transplantation in a large university hospital, in which yearly on average 20 organ donation procedures are being performed.

Methods

A prospective database was retrospectively analyzed to identify potential DCD II donors among patients who were admitted to the emergency department (ER) from 2010 until 2012. Data on cardiac resuscitation, age, medical history, and national donor registry status were collected.

Results

In total, 298 patients had out of hospital cardiac arrest; 98 (32.8%) died in hospital and met the medical and age inclusion criteria for both lung (age ≤65) and kidney donation (age ≤50).

Forty-two patients (42/98; 42.8%) died in the ER of which 14 (33.3%) could have been both DCD II lung and kidney donor, and 11 (26.2%) only DCD II lung donor.

Fifty-three patients (53/98; 54.1%) died in the intensive care unit (ICU) and could have been a DCD III donor. Two out of 53 (3.8%) patients had a second episode of cardiac arrest and could have been a DCD II donor in the ICU.

Three out of 98 (3.1%) patients died in the cardiac catheterization unit and could have been a DCD II lung donor.

Conclusions

In three years time in the emergency department of a university hospital, 25 patients proved to be potential DCD II lung or kidney donors after unsuccessful resuscitation for cardiac arrest, 2 patients proved to be potential DCD II donor in the ICU, and 3 patients at the cardiac catheterization unit.

This programme of lung and kidney donation could be an important source of donor organs to expand the existing donor pool by 50%.


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