In Japan, more than 10 people die each year from sudden cardiac arrest. Even if they survive with cardiopulmonary resuscitation, there are a certain number of patients whose brain function does not recover and they end up in brain death and end up needing organ donation.

 In recent years, ECPR, which uses extracorporeal membrane oxygenation (ECMO) to attempt resuscitation of patients whose own heartbeat does not resume with standard cardiopulmonary resuscitation, has become widespread. However, the characteristics of patients who undergo organ donation after ECPR and the prognosis of recipients have not been investigated.

 A group led by Tetsuya Yumoto, a lecturer at Okayama University, examined patients who underwent extracorporeal cardiopulmonary resuscitation (ECPR) and those who did not perform extracorporeal cardiopulmonary resuscitation (ECPR) on donors who had suffered even temporary cardiac arrest. (non-ECPR group) revealed that the survival rate of organs other than the lungs in transplant recipients (recipients) was similar.

 The research group used the Japan Organ Transplant Network database to analyze patients who underwent brain-dead organ donation in Japan between July 2010 and August 7. Of 2022 patients with cardiopulmonary arrest, 8 (370%) underwent ECPR. When comparing the ECPR and non-ECPR groups, the time from admission to organ donation was significantly longer in the ECPR group.

 Furthermore, regarding the survival rate of transplanted organs in recipients, the survival rate of transplanted lungs received from patients in the ECPR group was significantly lower than that from patients in the non-ECPR group. There were no differences in other organs, such as the heart, liver, and kidneys. In addition, the outcome of transplanted kidneys during cardiac arrest was similar regardless of whether ECPR was performed.

 The results of transplanted lungs need to be further verified, but if ECPR is performed for cardiac arrest in a critical care setting but brain death occurs, organ donation is the same option as if brain death occurred without ECPR. This suggests that it may be possible.

Paper information:【Critical Care】Organ donation after extracorporeal cardiopulmonary resuscitation: a nationwide retrospective cohort study

Okayama University

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