Out-of-hospital traumatic cardiac arrest: an underrecognized source of organ donors

Transpl Int. 2014 Jan;27(1):42-8. doi: 10.1111/tri.12196. Epub 2013 Oct 24.

Abstract

Whereas the gap between organ supply and demand remains a worldwide concern, resuscitation of out-of-hospital traumatic cardiac arrest (TCA) remains controversial. The aim of this study is to evaluate, in a prehospital medical care system, the number of organs transplanted from victims of out-of-hospital TCA. This is a descriptive study. Victims of TCA are collected in the out-of-hospital cardiac arrest registry of the French North Alpine Emergency Network from 2004 to 2008. In addition to the rates of admission and survival, brain-dead patients and the organ transplanted are described. Among the 540 resuscitated patients with suspected TCA, 79 were admitted to a hospital, 15 were discharged alive from the hospital, and 22 developed brain death. Nine of these became eventually organ donors, with 31 organs transplanted, all functional after 1 year. Out-of-hospital TCA should be resuscitated just as medical CA. With a steady prevalence in our network, 19% of admitted TCA survived to discharge, and 11% became organ donors. It is essential to raise awareness among rescue teams that out-of-hospital TCA are an organ source to consider seriously.

Keywords: donation; donor identification; expanded donor pool; out-of-hospital; traumatic cardiac arrest.

MeSH terms

  • Adult
  • Brain Death
  • Cardiopulmonary Resuscitation
  • Female
  • France / epidemiology
  • Heart Arrest / mortality*
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Registries
  • Tissue Donors / supply & distribution*
  • Wounds and Injuries / mortality*