Organ donation from extracorporeal membrane oxygenation and ventricular assist devices in Victoria, Australia: Characteristics and trends.

OBJECTIVE

To describe the characteristics and the trend of organ donation from donors on extracorporeal membrane oxygenation (ECMO) or ventricular assist devices (LVAD).

DESIGN

Retrospective, observational, cohort study from June 2014 to June 2021.

SETTING

A multicentre study in Victoria, Australia, using DonateLife Victoria databases.

PARTICIPANTS

All patients on ECMO/LVAD were referred to DonateLife for organ donation.

MAIN OUTCOME MEASURES

Number, proportion, time trend and type of organ donations from the patients on ECMO/LVAD.

RESULTS

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 %).

CONCLUSION

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.