Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Annals of Intensive Care
Published in: Annals of Intensive Care 1/2022

01-12-2022 | Shock | Research

Organ donation after out-of-hospital cardiac arrest: a population-based study of data from the Paris Sudden Death Expertise Center

Authors: M. Renaudier, Y. Binois, F. Dumas, L. Lamhaut, F. Beganton, D. Jost, J. Charpentier, O. Lesieur, E. Marijon, X. Jouven, A. Cariou, W. Bougouin, Paris Sudden Death Expertise Center group

Published in: Annals of Intensive Care | Issue 1/2022

Login to get access

Abstract

Background

Organ shortage is a major public health issue, and patients who die after out-of-hospital cardiac arrest (OHCA) could be a valuable source of organs. Here, our objective was to identify factors associated with organ donation after brain death complicating OHCA, in unselected patients entered into a comprehensive real-life registry covering a well-defined geographic area.

Methods

We prospectively analyzed consecutive adults with OHCA who were successfully resuscitated, but died in intensive care units in the Paris region in 2011–2018. The primary outcome was organ donation after brain death. Independent risk factors were identified using logistic regression analysis. One-year graft survival was assessed using Cox and log-rank tests.

Results

Of the 3061 included patients, 136 (4.4%) became organ donors after brain death, i.e., 28% of the patients with brain death. An interaction between admission pH and post-resuscitation shock was identified. By multivariate analysis, in patients with post-resuscitation shock, factors associated with organ donation were neurological cause of OHCA (odds ratio [OR], 14.5 [7.6–27.4], P < 0.001), higher pH (OR/0.1 increase, 1.3 [1.1–1.6], P < 0.001); older age was negatively associated with donation (OR/10-year increase, 0.7 [0.6–0.8], P < 0.001). In patients without post-resuscitation shock, the factor associated with donation was neurological cause of OHCA (OR, 6.9 [3.0–15.9], P < 0.001); higher pH (OR/0.1 increase, 0.8 [0.7–1.0], P = 0.04) and OHCA at home (OR, 0.4 [0.2–0.7], P = 0.006) were negatively associated with organ donation. One-year graft survival did not differ according to Utstein characteristics of the donor.

Conclusions

4% of patients who died in ICU after OHCA led to organ donation. Patients with OHCA constitute a valuable source of donated organs, and special attention should be paid to young patients with OHCA of neurological cause.
Appendix
Available only for authorised users
Literature
1.
2.
Luc G, Baert V, Escutnaire J, Genin M, Vilhelm C, Di Pompéo C, et al. Epidemiology of out-of-hospital cardiac arrest: a French national incidence and mid-term survival rate study. Anaesth Crit Care Pain Med. 2019;38(2):131–5.PubMedCrossRef
3.
Bougouin W, Lamhaut L, Marijon E, Jost D, Dumas F, Deye N, et al. Characteristics and prognosis of sudden cardiac death in Greater Paris: population-based approach from the Paris Sudden Death Expertise Center (Paris—SDEC). Intensive Care Med. 2014;40(6):846–54.PubMedCrossRef
4.
Sasson C, Rogers MAM, Dahl J, Kellermann AL. Predictors of survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2010;3(1):63–81.PubMedCrossRef
5.
Nakahara S, Tomio J, Ichikawa M, Nakamura F, Nishida M, Takahashi H, et al. Association of bystander interventions with neurologically intact survival among patients with bystander-witnessed out-of-hospital cardiac arrest in Japan. JAMA. 2015;314(3):247.PubMedCrossRef
6.
Sandroni C, D’Arrigo S, Callaway CW, Cariou A, Dragancea I, Taccone FS, et al. The rate of brain death and organ donation in patients resuscitated from cardiac arrest: a systematic review and meta-analysis. Intensive Care Med. 2016;42(11):1661–71.PubMedPubMedCentralCrossRef
7.
Adrie C, Haouache H, Saleh M, Memain N, Laurent I, Thuong M, et al. An underrecognized source of organ donors: patients with brain death after successfully resuscitated cardiac arrest. Intensive Care Med. 2008;34(1):132–7.PubMedCrossRef
8.
Cheetham OV, Thomas MJC, Hadfield J, O’Higgins F, Mitchell C, Rooney KD. Rates of organ donation in a UK tertiary cardiac arrest centre following out-of-hospital cardiac arrest. Resuscitation. 2016;101:41–3.PubMedCrossRef
9.
Lunz D, Calabrò L, Belliato M, Contri E, Broman LM, Scandroglio AM, et al. Extracorporeal membrane oxygenation for refractory cardiac arrest: a retrospective multicenter study. Intensive Care Med. 2020;46(5):973–82.PubMedCrossRef
10.
Sandroni C, Adrie C, Cavallaro F, Marano C, Monchi M, Sanna T, et al. Are patients brain-dead after successful resuscitation from cardiac arrest suitable as organ donors? A systematic review. Resuscitation. 2010;81(12):1609–14.PubMedCrossRef
11.
Orioles A, Morrison WE, Rossano JW, Shore PM, Hasz RD, Martiner AC, et al. An under-recognized benefit of cardiopulmonary resuscitation: organ transplantation*. Crit Care Med. 2013;41(12):2794–9.PubMedCrossRef
12.
West S, Soar J, Callaway CW. The viability of transplanting organs from donors who underwent cardiopulmonary resuscitation: a systematic review. Resuscitation. 2016;108:27–33.PubMedCrossRef
13.
Youn TS, Greer DM. Brain death and management of a potential organ donor in the intensive care unit. Crit Care Clin. 2014;30(4):813–31.PubMedCrossRef
14.
Kotloff RM, Blosser S, Fulda GJ, Malinoski D, Ahya VN, Angel L, et al. Management of the Potential Organ Donor in the ICU: Society of Critical Care Medicine/American College of Chest Physicians/Association of Organ Procurement Organizations Consensus Statement. Crit Care Med. 2015;43(6):1291–325.PubMedCrossRef
15.
Elmer J, Molyneaux BJ, Shutterly K, Stuart SA, Callaway CW, Darby JM, et al. Organ donation after resuscitation from cardiac arrest. Resuscitation. 2019;145:63–9.PubMedPubMedCentralCrossRef
16.
Reynolds JC, Rittenberger JC, Callaway CW. Patterns of organ donation among resuscitated patients at a regional cardiac arrest center. Resuscitation. 2014;85(2):248–52.PubMedCrossRef
17.
Bougouin W, Dumas F, Lamhaut L, Marijon E, Carli P, Combes A, et al. Extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest: a registry study. Eur Heart J. 2020;41(21):1961–71.PubMedCrossRef
18.
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344–9.CrossRef
19.
20.
Thuong M, Ruiz A, Evrard P, Kuiper M, Boffa C, Akhtar MZ, et al. New classification of donation after circulatory death donors definitions and terminology. Transpl Int. 2016;29(7):749–59.PubMedCrossRef
21.
Cour M, Turc J, Madelaine T, Argaud L. Risk factors for progression toward brain death after out-of-hospital cardiac arrest. Ann Intensive Care. 2019;9(1):45.PubMedPubMedCentralCrossRef
22.
Wijdicks EFM, Varelas PN, Gronseth GS, Greer DM, American Academy of Neurology. American Academy of Neurology Evidence-based guideline update: determining brain death in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2010;74(23):1911–8.PubMedCrossRef
23.
Jousset N, Gaudin A, Mauillon D, Penneau M, Rougé-Maillart C. Organ donation in France: legislation, epidemiology and ethical comments. Med Sci Law. 2009;49(3):191–9.PubMedCrossRef
24.
25.
Langhelle A, Nolan J, Herlitz J, Castren M, Wenzel V, Soreide E, et al. Recommended guidelines for reviewing, reporting, and conducting research on post-resuscitation care: the Utstein style. Resuscitation. 2005;66(3):271–83.PubMedCrossRef
26.
Arnaout M, Mongardon N, Deye N, Legriel S, Dumas F, Sauneuf B, et al. Out-of-hospital cardiac arrest from brain cause: epidemiology, clinical features, and outcome in a multicenter cohort*. Crit Care Med. 2015;43(2):453–60.PubMedCrossRef
27.
Legriel S, Bougouin W, Chocron R, Beganton F, Lamhaut L, Aissaoui N, et al. Early in-hospital management of cardiac arrest from neurological cause: diagnostic pitfalls and treatment issues. Resuscitation. 2018;132:147–55.PubMedCrossRef
28.
Lemiale V, Dumas F, Mongardon N, Giovanetti O, Charpentier J, Chiche J-D, et al. Intensive care unit mortality after cardiac arrest: the relative contribution of shock and brain injury in a large cohort. Intensive Care Med. 2013;39(11):1972–80.PubMedCrossRef
29.
30.
Madelaine T, Cour M, Roy P, Vivien B, Charpentier J, Dumas F, et al. Prediction of brain death after out-of-hospital cardiac arrest. Chest. 2021;160(1):139–47.PubMedCrossRef
31.
Christ M, von Auenmüller K, Brand M, Gessner V, Grett M, Zalloum N, et al. Organspende bei Patienten nach nicht traumatischem außerklinischem Herzstillstand. DMW - Dtsch Med Wochenschr janv. 2018;143(01):e1-8.CrossRef
32.
Jozwiak M, Bougouin W, Geri G, Grimaldi D, Cariou A. Post-resuscitation shock: recent advances in pathophysiology and treatment. Ann Intensive Care. 2020;10(1):170.PubMedPubMedCentralCrossRef
33.
Dayoub JC, Cortese F, Anžič A, Grum T, de Magalhães JP. The effects of donor age on organ transplants: a review and implications for aging research. Exp Gerontol sept. 2018;110:230–40.CrossRef
34.
35.
36.
Chocron R, Bougouin W, Beganton F, Juvin P, Loeb T, Adnet F, et al. Are characteristics of hospitals associated with outcome after cardiac arrest? Insights from the Great Paris registry. Resuscitation. 2017;118:63–9.PubMedCrossRef
Metadata
Title
Organ donation after out-of-hospital cardiac arrest: a population-based study of data from the Paris Sudden Death Expertise Center
Authors
M. Renaudier
Y. Binois
F. Dumas
L. Lamhaut
F. Beganton
D. Jost
J. Charpentier
O. Lesieur
E. Marijon
X. Jouven
A. Cariou
W. Bougouin
Paris Sudden Death Expertise Center group
Publication date
01-12-2022
Publisher
Springer International Publishing
Published in
Annals of Intensive Care / Issue 1/2022
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-022-01023-7

Other articles of this Issue 1/2022

Annals of Intensive Care 1/2022 Go to the issue

Review

Timing of vasoactive agents and corticosteroid initiation in septic shock

Review

Intravenous fluid therapy in patients with severe acute pancreatitis admitted to the intensive care unit: a narrative review

Letter to the Editor

Intensive care unit-to-unit capacity transfers are associated with increased mortality: no hasty conclusions in the event of a crisis

Research

Clinical outcome of wild-type AmpC-producing Enterobacterales infection in critically ill patients treated with β-lactams: a prospective multicenter study

Letter to the Editor

Aerosolized polymyxins for ventilator-associated pneumonia caused by extensive drug resistant Gram-negative bacteria: class, dose and manner should remain the trifecta

Research

Association of sepsis-induced cardiomyopathy and mortality: a systematic review and meta-analysis