Assessing unrealised potential for organ donation after out-of-hospital cardiac arrest

Table 1 Constituent Factors and Projected Donor Numbers per uDCD Criteria

		uDCD Criteria
		Madrid¹³	San Carlos, Madrid¹⁴	Maastricht¹⁵		Paris¹⁶
		Madrid¹³	San Carlos, Madrid¹⁴	Best-case	Worst-case	Best-case	Worst-case
Factors	Age (years)	18–60	7–55	< 65		18–55
	Witnessed OHCA	Yes	Yes	Yes		Yes
	Cardiac Arrest to CPR Initiation (min)	< 15	< 10	< 45		< 30
	Comorbidities for Exclusion	1. Unknown cause of death 2. Risk factors for HIV^† 3. Trauma to chest or abdomen	1. Unknown cause of death 2. Risk factors for HIV 3. Trauma to chest or abdomen	–	1. Infection	1. Hypertension 2. Diabetes 3. Cancer 4. Renal disease 5. Trauma to abdomen	1. Hypertension 2. Diabetes 3. Cancer 4. Renal disease 5. Trauma to abdomen 6. Infection
Projected Patient Numbers	Eligible for uDCD (% of total)	1202 (9.6)	660 (5.3)	2460 (19.6)	1987 (15.8)	648 (5.2)	544 (4.3)
	Eligible for ECPR (% of uDCD)	208 (17.3)	152 (23.0)	266 (10.8)	266 (13.4)	102 (15.7)	102 (18.8)
	ECPR Survivors^‡	25	18	32	32	12	12
	Potential uDCD Donors (% of total)^††	1177 (9.4)	642 (5.1)	2428 (19.4)	1955 (15.6)	636 (5.1)	532 (4.2)
	Potential uDCD Donors (ppm/year)^§	31.7	17.3	65.4	52.7	17.1	14.3

^† HIV=Human Immunodeficiency Virus
^‡ Refers to the estimated number of OHCA patients eligible for uDCD and ECPR that survive neurologically intact if ECPR was administered. This is obtained by multiplying the projected number of ECPR cases by 12.3% and rounding down to the nearest whole number (12.3% estimate derived from Sakamoto et al.³⁴)
^†† Refers to the final estimate of national uDCD donors. This is obtained by deducting ECPR survivors from the number eligible for uDCD
^§ Assuming a resident population of 5.3 million across all 7 years of data (actual 2010 population 5.1 million; 2016 population 5.6 million). Current DBD donor rate is approximately 6.6 ppm/year

ISSN: 1757-7241