Nainani Viveka K, Arcia Byron, Pilcher David, Ihle Joshua, Diehl Arne, Radford Samuel, D'Costa Rohit, Nanjayya Vinodh B
Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, Victoria, Australia.
DonateLife, The Australian Organ and Tissue Authority, ACT, Australia.
Crit Care Resusc. 2025 Mar 13;27(1):100102. doi: 10.1016/j.ccrj.2025.100102. eCollection 2025 Mar.
To describe the characteristics and the trend of organ donation from donors on extracorporeal membrane oxygenation (ECMO) or ventricular assist devices (LVAD).
Retrospective, observational, cohort study from June 2014 to June 2021.
A multicentre study in Victoria, Australia, using DonateLife Victoria databases.
All patients on ECMO/LVAD were referred to DonateLife for organ donation.
Number, proportion, time trend and type of organ donations from the patients on ECMO/LVAD.
There were 78 donor referrals [mean (SD) age 42 (18.8) yrs, 56 (72 %) males] from patients on Veno-arterial ECMO (73 %), Veno-venous ECMO (16 %) or LVAD (6.4 %), of which 37 (47 %) donated. The annual median (IQR) referral and donation rates were 8 (5-10)/year and 4 (3-7)/year, respectively. Medical contraindications were the main reason for declining organ donation [21(51 %)]. Donation after neurological determination of death (DNDD) occurred in 20 (54 %), and donation after circulatory determination of death (DCDD) in 17 (46 %). The median (IQR) time from admission to referral for donation was longer in DCDD compared to DNDD patients. Eighty-three organs were retrieved from 37 donors (2.24 organs per donor), out of which 68 organs (82 %) were transplanted in 68 recipients. Kidneys were the most common organs retrieved (73 %) and transplanted (79 %).
Organ donation on ECMO/LVAD occurs only in half of the referred patients. Further studies are needed to ascertain the barriers to donations and to assess the long-term outcomes of these donations.
描述接受体外膜肺氧合（ECMO）或心室辅助装置（LVAD）的供体的器官捐献特征及趋势。
2014年6月至2021年6月的回顾性观察队列研究。
澳大利亚维多利亚州的一项多中心研究，使用维多利亚州器官捐献数据库。
所有接受ECMO/LVAD治疗的患者均被转介至器官捐献机构进行器官捐献。
接受ECMO/LVAD治疗的患者的器官捐献数量、比例、时间趋势及类型。
共有78例来自接受静脉-动脉ECMO（73%）、静脉-静脉ECMO（16%）或LVAD（6.4%）治疗患者的供体转介[平均（标准差）年龄42（18.8）岁，56例（72%）为男性]，其中37例（47%）进行了捐献。每年的中位（四分位间距）转介率和捐献率分别为8（5 - 10）例/年和4（3 - 7）例/年。医学禁忌是拒绝器官捐献的主要原因[21例（51%）]。经神经学判定死亡后捐献（DNDD）的有20例（54%），经循环判定死亡后捐献（DCDD）的有17例（46%）。与DNDD患者相比，DCDD患者从入院到转介进行捐献的中位（四分位间距）时间更长。从37例供体中获取了83个器官（每位供体2.24个器官），其中68个器官（82%）移植给了68例受者。肾脏是获取（73%）和移植（79%）最常见的器官。
接受ECMO/LVAD治疗的患者中只有一半进行了器官捐献。需要进一步研究以确定捐献的障碍并评估这些捐献的长期结果。
