Potential of Donation After Unexpected Circulatory Death Programs Defined by Their Demographic Characteristics.

Autor:	Brat A; Department of Surgery, University Medical Center of Groningen, Groningen, The Netherlands., Venema LH; Department of Surgery, University Medical Center of Groningen, Groningen, The Netherlands., Bens BWJ; Department of Emergency Medicine, University Medical Center of Groningen, Groningen, The Netherlands., Stieglis R; Department of Cardiology, Amsterdam UMC, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands., van der Heijden JJ; Department of Intensive Care, University Medical Center Utrecht, Utrecht, The Netherlands., Fondevila C; Department of General and Digestive Surgery, Hospital Clinic, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain., Reznik ON; Organ Transplant Department, Saint Petersburg Pavlov State Medical University, Saint Petersburg, Russia., Barrou B; Department of Urology, Nephrology and Transplantation, Groupe Hospitalier Pitié -Salpêtrière, Paris, France., Erasmus ME; Department of Thoracic Surgery, University Medical Center of Groningen, Groningen, The Netherlands., Leuvenink HGD; Department of Surgery, University Medical Center of Groningen, Groningen, The Netherlands.
Jazyk:	angličtina
Zdroj:	Transplantation direct [Transplant Direct] 2021 Dec 23; Vol. 8 (1), pp. e1263. Date of Electronic Publication: 2021 Dec 23 (Print Publication: 2022).
DOI:	10.1097/TXD.0000000000001263
Abstrakt:	Background: Donation after unexpected circulatory death (uDCD) donors are often suggested to increase the number of donor organs. In 2014, a uDCD protocol was implemented in three transplant centers in the Netherlands which unfortunately did not result in additional transplantations. This study was initiated to identify demographic factors influencing the potential success of uDCD programs. Methods: Dutch resuscitation databases covering various demographic regions were analyzed for potential donors. The databases were compared with the uDCD implementation project and successful uDCD programs in Spain, France, and Russia. Results: The resuscitation databases showed that 61% of all resuscitated patients were transferred to an emergency department. Age selection reduced this uDCD potential to 46% with only patients aged 18-65 years deemed eligible. Of these patients, 27% died in the emergency department. The urban region of Amsterdam showed the largest potential in absolute numbers (52 patients/y). Comparison with the uDCD implementation project showed large similarities in the percentage of potential donors; however, in absolute numbers, it showed a much smaller potential. Calculation of the potential per million persons and the extrapolation of the potential based on the international experience revealed the largest potential in urban regions. Conclusions: Implementation of a uDCD program should not only be based on the number of potential donors calculated from resuscitation databases. They show promising potential uDCD percentages for large rural regions and small urban regions; however, actual numbers per hospital are low, leading to insufficient exposure rates. It is, therefore, recommendable to limit uDCD programs to large urban regions. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2021 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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