An under-recognized benefit of cardiopulmonary resuscitation: organ transplantation.
OBJECTIVE
For many patients who suffer cardiac arrest, cardiopulmonary resuscitation does not result in long-term survival. For some of these patients, the evolution to donation of organs becomes an option. Organ transplantation after cardiopulmonary resuscitation is not reported as an outcome of cardiopulmonary resuscitation and is therefore overlooked. We sought to determine the number and proportion of organs transplanted from donors who received cardiopulmonary resuscitation after a cardiac arrest in the United States and to compare survival of organs from donors who had cardiopulmonary resuscitation (cardiopulmonary resuscitation organs) versus donors who did not have resuscitation (noncardiopulmonary resuscitation organs).


METHODS
We retrospectively analyzed a nationwide, population-based database of all organ donors and recipients from the United Network for Organ Sharing between July 1999 and June 2011.


METHODS
We queried the database for all organs from deceased donors between July 1999 and June 2011. Organs from living donors (n = 76,015), all organs with missing cardiopulmonary resuscitation data (n = 59), and organs procured following a circulatory determination of death (n = 12,030) were excluded.


METHODS
We report donor demographic data and organ survival outcomes among organs from donors who received cardiopulmonary resuscitation (cardiopulmonary resuscitation organs) and donors who had not received cardiopulmonary resuscitation (noncardiopulmonary resuscitation organs). Graft survival of cardiopulmonary resuscitation organs versus noncardiopulmonary resuscitation organs was compared using Kaplan-Meier estimates and stratified log-rank test.


RESULTS
In the United States, among the 224,076 organs donated by donors who were declared dead by neurologic criteria between 1999 and 2011, at least 12,351 organs (5.5%) were recovered from donors who received cardiopulmonary resuscitation. Graft survival of cardiopulmonary resuscitation organs was not significantly different than that of noncardiopulmonary resuscitation organs.


CONCLUSIONS
At least 1,000 organs transplanted per year in the United States (> 5% of all organs transplanted from patients declared dead by neurologic criteria) are recovered from patients who received cardiopulmonary resuscitation. Organ recovery and successful transplantation is an unreported beneficial outcome of cardiopulmonary resuscitation.
1Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA. 2Department of Pediatrics, Cardiac Center, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA. 3Department of Pediatrics, Saint Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA. 4Gift of Life Donor Program, Philadelphia, PA.
Alberto
A
Orioles
Wynne E
WE
Morrison
Joseph W
JW
Rossano
Paul M
PM
Shore
Richard D
RD
Hasz
Amy C
AC
Martiner
Robert A
RA
Berg
Vinay M
VM
Nadkarni
D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data*; D006085:Graft Survival; D006323:Heart Arrest / Q000628:therapy; D006801:Humans; D016377:Organ Transplantation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting / Q000706:statistics & numerical data*; D014481:United States