title: Enhancing the tissue donor pool through donation after death in the field.
abstract: BACKGROUND
  Tissue transplantation is an important adjunct to modern medical care and is used daily to save or improve patient lives. Tissue allografts include bone, tendon, corneas, heart valves and others. Increasing utilization may lead to tissue shortages, and tissue procurement organizations continue to explore ways to expand the cadaveric donor pool. Currently more than half of all deaths occur outside the acute care setting.
  
  
  OBJECTIVE
  Many who suffer prehospital deaths might be eligible for non-organ tissue donation.
  
  
  METHODS
  A retrospective review of electronic prehospital medical records was conducted from May 1, 2008 through December 31, 2009. All prehospital deaths were included irrespective of cause. Once identified, additional medical history was obtained from prehospital, inpatient, and emergency department records. Age, medical history, and time of death were compared to exclusion criteria for four tissue procurement organizations (MTF, LifeNet, LifeCell, EyeBank). After analysis, percentages of eligible donors were calculated.
  
  
  RESULTS
  Over 50,000 prehospital records were reviewed; 432 subjects died in the field and were eligible for analysis. Ages ranged from four to 103 years of age; the average was 68.3 (SD = 20.1) years. After exclusion for age, medical conditions, and time of death, 185 unique patients (42.8%) were eligible for donation to at least one of the four tissue procurement organizations (range 11.6%-34.3%).
  
  
  CONCLUSIONS
  After prehospital death, many individuals may be eligible for tissue donation. These findings suggest that future prospective studies exploring tissue donation after prehospital death are indicated. These studies should aim to clarify eligibility criteria, create protocols and infrastructure, and explore the ethical implications of expanding tissue donation to include this population.
authors: Department of Surgery, Division of Acute Care Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey 08901, USA.
authors: Adam M
authors: AM
authors: Shiroff
authors: Stephen C
authors: SC
authors: Gale
authors: Mark A
authors: MA
authors: Merlin
authors: Jessica S
authors: JS
authors: Crystal
authors: Matt
authors: M
authors: Linger
authors: Anar D
authors: AD
authors: Shah
authors: Erin
authors: E
authors: Beaumont
authors: Elie
authors: E
authors: Lustiger
authors: Erica
authors: E
authors: Tabakin
authors: Vicente H
authors: VH
authors: Gracias
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009515:New Jersey; D012189:Retrospective Studies; D014019:Tissue Donors; D009927:Tissue and Organ Procurement