title: Hypothermia in organ donation: a friend or foe?
abstract: BACKGROUND
  Hypothermia is a known predictor of mortality in trauma patients; however, its impact on organ procurement has not been defined. The aim of this study was to assess the effect of hypothermia on organ procurement. We hypothesized that admission hypothermia impedes successful organ procurement.
  
  
  METHODS
  We performed a 5-year retrospective analysis of all trauma patients approached for organ donation. Hypothermia was defined as a core body temperature 36°C/97°F or less. The two groups (hypothermic [HT] vs. nonhypothermic [non-HT]) were matched in a 1:1 ratio using propensity score matching for age, sex, admission Glasgow Coma Scale (GCS) score, systolic blood pressure, international normalized ratio, and Injury Severity Score (ISS). Primary outcome measures were eligibility for organ donation and solid organ procurement. Secondary outcome measures were blood product and vasopressor requirements.
  
  
  RESULTS
  This study was composed of 537 brain-dead patients, of whom 416 (HT, 208; non-HT, 208) were included in the analysis. The mean (SD) age was 40.5 (23.7) years, 75% were male, mean (SD) temperature was 36.6°C (1.7°C), and mean (SD) systolic blood pressure was 75.35 (68.7) mm Hg. Patients who were hypothermic on presentation were less likely to be eligible for organ donation (44.7% vs. 96%, p ≤ 0.001), and they donated fewer organs per donor (p = 0.04). HT patients required more units of fresh frozen plasma (p = 0.04) and greater mean dose of dopamine (p = 0.03) and vasopressin (p = 0.03) compared with the non-HT patients.
  
  
  CONCLUSIONS
  Admission hypothermia is associated with decreased organ donation in potential organ donors independent of admission coagulopathy, hypotension, and injury severity. Early correction of hypothermia may improve organ donation in trauma patients.
  
  
  METHODS
  Epidemiologic/prognostic study, level III.
authors.affiliation: From the Division of Trauma, Emergency Surgery, Critical Care, and Burns, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Bellal
authors.initials: B
authors.lastname: Joseph
authors.forename: Mazhar
authors.initials: M
authors.lastname: Khalil
authors.forename: Viraj
authors.initials: V
authors.lastname: Pandit
authors.forename: Narong
authors.initials: N
authors.lastname: Kulvatunyou
authors.forename: Bardiya
authors.initials: B
authors.lastname: Zangbar
authors.forename: Andrew
authors.initials: A
authors.lastname: Tang
authors.forename: Terence
authors.initials: T
authors.lastname: O'Keeffe
authors.forename: Kara
authors.initials: K
authors.lastname: Snyder
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Green
authors.forename: Lynn
authors.initials: L
authors.lastname: Gries
authors.forename: Randall S
authors.initials: RS
authors.lastname: Friese
authors.forename: Peter
authors.initials: P
authors.lastname: Rhee
mesh_terms: D000328:Adult; D001926:Brain Death; D005260:Female; D006801:Humans; D007035:Hypothermia / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012189:Retrospective Studies; D014019:Tissue Donors / Q000706:statistics & numerical data*; D020858:Tissue and Organ Harvesting; D009927:Tissue and Organ Procurement; D014947:Wounds and Injuries / Q000401:mortality*; D055815:Young Adult