D'Aragon Frederick, Lachance Olivier, Lafleur Vincent, Ortega-Deballon Ivan, Masse Marie-Helene, Trepanier Gabrielle, Lamarche Daphnee, Battista Marie-Claude
Department of Anesthesiology, Faculty of Medicine and Health Sciences Université de Sherbrooke, Sherbrooke, Quebec, Canada.
Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada.
Open Access Emerg Med. 2022 Aug 5;14:413-420. doi: 10.2147/OAEM.S361930. eCollection 2022.
Worldwide, the number of patients waiting for organ transplantation exceeds the number of organs available. Program for uncontrolled donation after circulatory death (uDCD) implemented in Europe has resulted in a 10-15% expansion of the donor pool. We aimed to describe the number of patients eligible for an uDCD program in a regional tertiary care center.
We conducted a retrospective cohort study in a Canadian tertiary academic center located in a rural area including all adults who received cardiopulmonary resuscitation in 2016 and died in the emergency department (ED) or during their hospitalization. The primary outcome was the number of patients eligible for uDCD defined as aged between 18 and 60 years old whose collapse was witnessed and where the time between cardiac arrest to cardiopulmonary resuscitation and ED arrival was, respectively, less than 30 and 120 minutes. As a secondary outcome, we determined the number of patients eligible for controlled donation after circulatory death.
Of the 130 patients included, 84 did not return to spontaneous circulation. We identified 15 potential uDCD candidates, with a mean age of 46.6 (95% Confidence Interval [CI] 41.3 to 52) years. Twelve had an out-of-hospital cardiac arrest with a mean time between collapse and arrival to the ED of 43.2 (29.8 to 56.6) minutes. Among the 46 patients who died after a return of spontaneous circulation, 10 (21.7%) were eligible for organ donation after circulatory death.
Implementing an uDCD program in a tertiary hospital covering a rural area could increase the number of donors.
在全球范围内，等待器官移植的患者数量超过了可用器官的数量。欧洲实施的循环死亡后非受控捐献（uDCD）计划使供体库扩大了10%至15%。我们旨在描述一家地区三级医疗中心符合uDCD计划的患者数量。
我们在加拿大农村地区的一家三级学术中心进行了一项回顾性队列研究，纳入了2016年接受心肺复苏并在急诊科（ED）或住院期间死亡的所有成年人。主要结局是符合uDCD的患者数量，定义为年龄在18至60岁之间、心跳骤停有目击者且心脏骤停至心肺复苏以及到达ED的时间分别少于30分钟和120分钟的患者。作为次要结局，我们确定了符合循环死亡后受控捐献的患者数量。
在纳入的130例患者中，84例未恢复自主循环。我们确定了15名潜在的uDCD候选者，平均年龄为46.6岁（95%置信区间[CI]41.3至52岁）。12例为院外心脏骤停，从心跳骤停至到达ED的平均时间为43.2分钟（29.8至56.6分钟）。在46例恢复自主循环后死亡的患者中，10例（21.7%）符合循环死亡后器官捐献的条件。
在覆盖农村地区的三级医院实施uDCD计划可以增加供体数量。
