Abstract 107: Organ Donation Increases Over Time at a Regional Cardiac Arrest Center
Objectives: As demand outpaces supply of organs for transplantation in the US, donation after cardiac death is increasing. Select patients resuscitated from cardiac arrest may be an under-recognized donor pool. Guidelines suggest that regional cardiac arrest centers address organ donation with non-survivors. The yield of organs from this population is unknown.
Methods: Retrospective cohort study of resuscitated atraumatic cardiac arrest patients between 2005-2011 at a transplant center that began service as a regional cardiac arrest center in 2007 with a formal cardiac arrest service (PCAS). We determined yield of organs from cardiac arrest patients, and used logistic regression to identify characteristics associated with donation. Linear regression assessed temporal trends in referral and donation.
Results: Of 991 resuscitated patients admitted between 2005-2011, 560 did not survive. Of these, 530 (94.6%) were referred to the organ procurement organization (OPO). Family refused donation in 71 otherwise suitable candidate donors. Overall, 75 of 560 (13.4%) patients had organs procured. Yield was 1.8 solid organs and 1.3 eyes per donor, with the majority being transplanted. Age (OR 0.94; 95% CI 0.92, 0.96; p<0.001), male sex (OR 0.54, 95% CI 0.33, 0.90; p=0.02), OHCA (OR 5.60; 95% CI 2.73, 11.51; p<0.001), and PCAS consult (OR 2.02; 95% CI 1.02, 4.02; p=0.04) were associated with procurement in univariate analysis. Age (0.94; 95% CI 0.93, 0.96; p<0.001) and OHCA (OR 3.96; 95% CI 1.82, 8.58; p=0.001) were associated with procurement in adjusted analysis. The number of OPO referrals (coefficient 15.2; 95%CI 10.0, 20.4; p=0.001), donors (coefficient 3.4; 95%CI 1.9, 5.0;p=0.002), and organs procured (coefficient 8.5; 95% CI 4.2, 12.8; p=0.004) increased over time. The probability of OPO referral did not change over years (OR 0.9; 95% CI 0.8, 1.2; p=0.57), but the probability of donation increased (OR 1.2; 95%CI 1.0, 1.4; p=0.02).
Conclusions: Institution of a formal cardiac arrest service and functioning as a regional cardiac arrest center resulted in an increase in organ donation over time. This role of a cardiac arrest center provides indirect benefit to other patients.
- © 2013 by American Heart Association, Inc.