目的:循环死亡测定(uDCD)后的非控制捐赠已经开发出来,可以作为移植肾脏的来源,特别是在考虑符合延长标准捐赠(ECD)的患者时。
目的:本研究评估了在院外心脏骤停(OHCA)后符合复苏终止(TOR)标准的患者中,具有标准标准捐赠(SCD)和ECD的潜在肾移植池的理论大小和特征。
方法:本研究集中于经历意外OHCA的成年患者,他们从5月16日开始在巴黎注册,2011年至12月31日,2020年。
结果:在研究期间,EMS尝试对19,976名OHCA患者进行复苏,其中64.5%(12,890)没有自发循环恢复。其中,47.4%(9,461)有TOR标准,代表没有生存的机会,从他们那里,8.8%(1,764)符合SCD标准,可能是潜在的器官捐献者,33.6%(6,720)符合肾脏捐献者的ECD。具有SCD和ECD的uDCD候选物每年的平均潜在数量保持稳定,分别在每年98(±10.8)例和672(±103.8)例左右。老年患者(≥65岁)占61.2%(n=5,763/9,461)符合TOR的患者和100%(5763/5763)符合ECD标准和TOR的患者。
结论:在TOR迅速确定的OHCA病例中实施uDCD计划,包括SCD和ECD用于肾移植,具有显著扩大器官捐献者群体的巨大潜力。这些计划可以提供一个可行的解决方案来解决肾脏短缺的紧迫负担,特别有利于老年接受者,否则他们可能面临长时间的等待时间和有限的获得合适器官的机会。
OBJECTIVE: Uncontrolled donation after circulatory determination of death (uDCD) has been developed and can serve as a source of kidneys for transplantation, especially when considering patients that meet extended criteria donation (ECD).
OBJECTIVE: This study assessed the theorical size and characteristics of the potential pool of kidney transplants from uDCD with standard criteria donation (SCD) and ECD among patients who meet Termination of Resuscitation (TOR) criteria following Out of Hospital Cardiac Arrest (OHCA).
METHODS: This study focused on adult patients experiencing unexpected OHCA, who were prospectively enrolled in the Parisian registry from May 16th, 2011, to December 31st, 2020.
RESULTS: During the study period, EMS attempted resuscitation for 19,976 OHCA patients, of which 64.5% (12,890) had no return of spontaneous circulation. Among them, 47.4% (9,461) had TOR criteria, representing no chance of survival, and from them, 8.8% (1,764) met SCD criteria and could be potential organ donors and 33.6% (6,720) met ECD for kidney donors. The mean potential number per year of uDCD candidates with SCD and ECD remain stable respectively around 98 (±10.8) and 672 (±103.8) cases per year. Elderly patients (≥65 y.o.) represented 61.2% (n = 5,763/9,461) of patients who met TOR and 100% (5763/5763) of patients who could have matched both ECD criteria and TOR.
CONCLUSIONS: Implementing uDCD program including SCD and ECD for kidney transplantation among OHCA cases quickly identified by the TOR, holds significant potential to substantially broaden the pool of organ donors. These programs could offer a viable solution to address the pressing burden of kidney shortage, particularly benefiting elderly recipients who may otherwise face prolonged waiting times and limited access to suitable organs.