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Krzysztof Pabisiak, Arkadiusz Krejczy, Grażyna Dutkiewicz, Krzysztof Safranow, Jerzy Sienko, Romuald Bohatyrewicz, Kazimierz Ciechanowski
(Department of Nephrology Transplantation and Internal Medicine, Pomeranian Medical University, Szczecin, Poland)
Ann Transplant 2016; 21:582-586
Donation after cardiac death offers the possibility of increasing the pool of organs for transplantation by up to 30%. Maastricht category type 3 (M3) dominates in most countries with active DCD programs. During preparations to introduce a permanent program for uncontrolled donation after circulatory death in Szczecin, Poland, the donor pool has been estimated. In Poland, Maastricht category type 2 (M2) is considered a basic source for organ recovery.
MATERIAL AND METHODS: This was a retrospective cohort study of out-of-hospital cardiac arrests (OHCA) reported to local Emergency Medical Services (EMS) between 1 December 2014 and 30 November 2015. The following inclusion criteria were used in the analysis: demographic (age 18–60 years, known identity), clinical (no chest or abdominal injury, no cachexia as an equivalent of wasting diseases), and organizational (weekdays from 8:00 am to 3:00 pm).
RESULTS: During 12-month period, 118 EMS interventions were recorded in response to sudden cardiac arrest. The stratification process mentioned above used criteria to establish potential, eligible, qualified, and actual donor pools (27 (30.3%), 24 (26.4%), 7 (7.3%), and 6 (6.7%), respectively). To establish a “virtual” actual number of uDCD, the nationwide average level of lack of authorization for donation was 12%.
CONCLUSIONS: Activation of a permanent program of organ recovery from uDCD would increase the donor pool by 6 cases. Compared to the number of brain-dead donors referred from regional hospitals, this increase would be equivalent to the formation of a new reporting center. The number of transplantable organs could increase by 22% per year.
Keywords: Death, Sudden, Cardiac, Donor Selection, out-of-hospital cardiac arrest, Tissue and Organ Procurement