title: Nonaccidental Out-of-Hospital Cardiac Arrest in an Urban Area as a Potential Source of Uncontrolled Organ Donors.
abstract: BACKGROUND 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.
authors.affiliation: Department of Nephrology Transplantation and Internal Medicine, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Pabisiak
authors.affiliation: , Emergecy Medical Services, Szczecin, Poland.
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Krejczy
authors.affiliation: Department of Nephrology Transplantation and Internal Medicine, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Grażyna
authors.initials: G
authors.lastname: Dutkiewicz
authors.affiliation: Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Safranow
authors.affiliation: Department of General Surgery and Transplantation, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Sienko
authors.affiliation: Department of Anesthesiology and Intensive Care, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Romuald
authors.initials: R
authors.lastname: Bohatyrewicz
authors.affiliation: Department of Nephrology Transplantation and Internal Medicine, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Kazimierz
authors.initials: K
authors.lastname: Ciechanowski
mesh_terms: D000293:Adolescent; D000328:Adult; D000066491:Clinical Decision-Making; D015331:Cohort Studies; D016757:Death, Sudden, Cardiac; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest; D011044:Poland; D012189:Retrospective Studies; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods* / Q000458:organization & administration; D055815:Young Adult