An underrecognized source of organ donors: patients with brain death after successfully resuscitated cardiac arrest.
OBJECTIVE
To identify predictors of brain death after successful resuscitation of out-of-hospital cardiac arrest (OHCA), with the goal of improving the detection of brain death, and to evaluate outcomes of solid organs harvested from these patients.


METHODS
Prospective observational cohort study in a medical and surgical unit of a nonuniversity hospital.


METHODS
Patients with successfully resuscitated OHCA were prospectively included in a database over a 7-year period. We looked for early predictors of brain death and compared outcomes of organ transplants from these patients to those from patients with brain death due to head injury or stroke.


RESULTS
Over the 7-year period 246 patients were included. No early predictors of brain death were found. Of the 40 patients (16%) who met criteria for brain death, after a median ICU stay of 2.5 days (IQR 2.0-4.2), 19 donated 52 solid organs (29 kidneys, 14 livers, 7 hearts, and 2 lungs). Outcomes of kidneys and livers did not differ between donors with and without resuscitated cardiac arrest.


CONCLUSIONS
Brain death may occur in about one-sixth of patients after successfully resuscitated OHCA, creating opportunities for organ donation.
Adrie
Christophe
C
Intensive Care Unit, Delafontaine Hospital, 2 rue du Dr Delafontaine, Saint Denis, France. christophe.adrie@wanadoo.fr
Haouache
Hakim
H
Saleh
Mohamed
M
Memain
Nathalie
N
Laurent
Ivan
I
Thuong
Marie
M
Darques
Loic
L
Guerrini
Patrice
P
Monchi
Mehran
M
D000328:Adult; D000368:Aged; D001926:Brain Death / Q000175:diagnosis*; D016887:Cardiopulmonary Resuscitation; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D009927:Tissue and Organ Procurement