Cardiac arrest & resuscitation
Organ donation after extracorporeal cardiopulmonary resuscitation for refractory out-of-hospital cardiac arrest in a metropolitan cardiac arrest centre in Milan, Italy
Authors' conclusion
When ECPR fails in patients with refractory OHCA, organ donation after brain or circulatory death can help a significant number of patients awaiting transplantation, enhancing the overall benefit of ECPR.
Study context
- Population
- Adults with refractory all-rhythms out-of-hospital cardiac arrest (OHCA) treated with extracorporeal cardiopulmonary resuscitation (ECPR), San Raffaele Hospital, Milan, Italy, January 2013-November 2022
- Participants
- 307 adults
- Outcome
- Rate of organ donation
Methodological detailssingle-centre, high-volume cardiac arrest centre, 95% witnessed, 66% shockable, low-flow 70 [IQR 58-81] minutes
- Single-centre
- High-volume cardiac arrest centre
- 95% witnessed, 66% shockable, low-flow 70 [IQR 58-81] minutes
Main finding
As reported in the abstract
Donation of ≥1 solid organ
- Donation of ≥1 solid organ
- 58 (19%)
- Donation after brain death
- 53 (17%)
- Donation after circulatory death
- 5 (1.6%)
- Total solid organs donated
- 167
- Organs per donor, median [IQR]
- 3.0 [IQR 2.5-4.0]
Observational data: associations, not effects.
Further findings
In-hospital death
- Died during hospital stay
- 256 (83%)
- Deaths from brain death
- 33%
Individuals possibly benefiting from ECPR
- Total individuals possibly benefiting
- 196
- Survivors with favourable neurological outcome
- 29
- Potential recipients of 1 solid organ
- 167
ECPR benefit composite (survival with favourable neurological outcome or donation of ≥1 solid organ)
- Composite achieved
- 87 (28%)
Solid organ donation by ECPR selection criteria
- Low-flow <60 min
- 16%
- Low-flow <60 min and initial shockable rhythm
- 11%
- Decreased from 19%
Original publication
Organ donation after extracorporeal cardiopulmonary resuscitation for refractory out-of-hospital cardiac arrest in a metropolitan cardiac arrest centre in Milan, Italy. Resuscitation. Published 10 April 2024. doi:10.
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