1Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA. 2Department of Pediatrics, Cardiac Center, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA. 3Department of Pediatrics, Saint Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA. 4Gift of Life Donor Program, Philadelphia, PA.
Crit Care Med. 2013 Dec;41(12):2794-9. doi: 10.1097/CCM.0b013e31829a7202.
For many patients who suffer cardiac arrest, cardiopulmonary resuscitation does not result in long-term survival. For some of these patients, the evolution to donation of organs becomes an option. Organ transplantation after cardiopulmonary resuscitation is not reported as an outcome of cardiopulmonary resuscitation and is therefore overlooked. We sought to determine the number and proportion of organs transplanted from donors who received cardiopulmonary resuscitation after a cardiac arrest in the United States and to compare survival of organs from donors who had cardiopulmonary resuscitation (cardiopulmonary resuscitation organs) versus donors who did not have resuscitation (noncardiopulmonary resuscitation organs).
We retrospectively analyzed a nationwide, population-based database of all organ donors and recipients from the United Network for Organ Sharing between July 1999 and June 2011.
We queried the database for all organs from deceased donors between July 1999 and June 2011. Organs from living donors (n = 76,015), all organs with missing cardiopulmonary resuscitation data (n = 59), and organs procured following a circulatory determination of death (n = 12,030) were excluded.
We report donor demographic data and organ survival outcomes among organs from donors who received cardiopulmonary resuscitation (cardiopulmonary resuscitation organs) and donors who had not received cardiopulmonary resuscitation (noncardiopulmonary resuscitation organs). Graft survival of cardiopulmonary resuscitation organs versus noncardiopulmonary resuscitation organs was compared using Kaplan-Meier estimates and stratified log-rank test.
In the United States, among the 224,076 organs donated by donors who were declared dead by neurologic criteria between 1999 and 2011, at least 12,351 organs (5.5%) were recovered from donors who received cardiopulmonary resuscitation. Graft survival of cardiopulmonary resuscitation organs was not significantly different than that of noncardiopulmonary resuscitation organs.
At least 1,000 organs transplanted per year in the United States (> 5% of all organs transplanted from patients declared dead by neurologic criteria) are recovered from patients who received cardiopulmonary resuscitation. Organ recovery and successful transplantation is an unreported beneficial outcome of cardiopulmonary resuscitation.
对于许多发生心脏骤停的患者来说，心肺复苏术并不能带来长期生存。对于其中一些患者，器官捐献成为一种选择。心肺复苏后器官移植并未被报告为心肺复苏术的结果，因此被忽视了。我们旨在确定在美国，有多少比例的心脏骤停后接受心肺复苏术的捐献者的器官被移植，并比较接受心肺复苏术（心肺复苏术器官）与未接受复苏术（非心肺复苏术器官）的捐献者的器官的存活率。
我们回顾性地分析了 1999 年 7 月至 2011 年 6 月期间美国所有器官共享网络的所有器官捐献者和接受者的全国性、基于人群的数据库。
我们查询了 1999 年 7 月至 2011 年 6 月期间所有已故捐献者的器官数据库。排除了来自活体捐献者的器官（n = 76,015）、所有心肺复苏数据缺失的器官（n = 59）和循环确定死亡后获取的器官（n = 12,030）。
我们报告了接受心肺复苏术（心肺复苏术器官）和未接受心肺复苏术（非心肺复苏术器官）的捐献者的器官的供体人口统计学数据和器官存活结果。使用 Kaplan-Meier 估计和分层对数秩检验比较心肺复苏术器官与非心肺复苏术器官的移植物存活率。
在美国，1999 年至 2011 年间，根据神经学标准宣布死亡的 224,076 名捐献者中，至少有 12,351 个器官（5.5%）是从接受心肺复苏术的捐献者中回收的。心肺复苏术器官的移植物存活率与非心肺复苏术器官无显著差异。
在美国，每年至少有 1000 个器官（超过所有根据神经学标准宣布死亡的患者移植器官的 5%）是从接受心肺复苏术的患者中回收的。器官回收和成功移植是心肺复苏术未被报告的有益结果。
