TY - JOUR
T1 - Organ Donor Potential After Extracorporeal Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest
T2 - A Post-Hoc Analysis of a Randomized Controlled Trial
AU - Verberght, Hanne C. R.
AU - Delnoij, Thijs S. R.
AU - Suverein, Martje M.
AU - Lunsing, Jody
AU - Hermanides, Renicus C.
AU - Otterspoor, Luuk
AU - Elzo Kraemer, Carlos V.
AU - Vlaar, Alexander P. J.
AU - Van Der Heijden, Joris J.
AU - Scholten, Erik
AU - Uil, Corstiaan A. Den
AU - Miranda, Dinis Dos Reis
AU - Akin, Sakir
AU - Metz, Jesse De
AU - Van Der Horst, Iwan C. C.
AU - Mathot, Bas J.
AU - De Jonge, Jeroen
AU - Nijboer, Mijntje W. N.
AU - De Meijer, Vincent E.
AU - Sanders, Jan S. F.
AU - Christiaans, Maarten H. L.
AU - Van Zuilen, Arjan D.
AU - Hagenaars, Hanneke
AU - Wind, Jentina
AU - Danhof, Miranda
AU - Olde Damink, Steven W. M.
AU - Winkens, Bjorn
AU - Maessen, Jos G.
AU - Lorusso, Roberto
AU - Van De Poll, Marcel C. G.
PY - 2025/11/1
Y1 - 2025/11/1
N2 - Background Extracorporeal cardiopulmonary resuscitation (ECPR) is a potentially life-saving intervention in refractory out-of-hospital cardiac arrest (OHCA). ECPR enables, in most of the treated cases, ICU admission to patients who otherwise would have died at the emergency department (ED). Still, many of them die, frequently after withdrawal of life-sustaining therapies due to irreversible critical conditions and related complications. The additional time provided by ECPR, however, might allow for the assessment of organ donor suitability. The aim of this study was to evaluate the impact of ECPR on the number of potential organ donors after refractory OHCA. Methods We performed a post-hoc analysis of the multicenter INCEPTION trial, which randomized 134 OHCA patients between conventional CPR (CCPR) and ECPR. Detailed patient reports were presented to transplant physicians to determine the acceptability of the liver and kidneys for organ donation. In addition to the intention to treat analysis, we performed an "as-treated" analysis, limited to patients arriving without return of spontaneous circulation (ROSC) at the ED. Results Out of 70 patients randomized to ECPR and 64 to CCPR, potential organ donors were identified in 14 (20%) and 4 (6%) patients, respectively (chi(2) test, p = 0.038). In the as-treated analysis, 15 out of 55 (27%) treated with ECPR were potential donors, compared to 0 out of 59 treated with CCPR (p < 0.001). This included five (9%) potential kidney donors and 15 (27%) potential liver donors. Conclusion Although ECPR is currently used with life-saving intentions, it may simultaneously increase the number of potential organ donors following cardiac arrest in selected patients.
AB - Background Extracorporeal cardiopulmonary resuscitation (ECPR) is a potentially life-saving intervention in refractory out-of-hospital cardiac arrest (OHCA). ECPR enables, in most of the treated cases, ICU admission to patients who otherwise would have died at the emergency department (ED). Still, many of them die, frequently after withdrawal of life-sustaining therapies due to irreversible critical conditions and related complications. The additional time provided by ECPR, however, might allow for the assessment of organ donor suitability. The aim of this study was to evaluate the impact of ECPR on the number of potential organ donors after refractory OHCA. Methods We performed a post-hoc analysis of the multicenter INCEPTION trial, which randomized 134 OHCA patients between conventional CPR (CCPR) and ECPR. Detailed patient reports were presented to transplant physicians to determine the acceptability of the liver and kidneys for organ donation. In addition to the intention to treat analysis, we performed an "as-treated" analysis, limited to patients arriving without return of spontaneous circulation (ROSC) at the ED. Results Out of 70 patients randomized to ECPR and 64 to CCPR, potential organ donors were identified in 14 (20%) and 4 (6%) patients, respectively (chi(2) test, p = 0.038). In the as-treated analysis, 15 out of 55 (27%) treated with ECPR were potential donors, compared to 0 out of 59 treated with CCPR (p < 0.001). This included five (9%) potential kidney donors and 15 (27%) potential liver donors. Conclusion Although ECPR is currently used with life-saving intentions, it may simultaneously increase the number of potential organ donors following cardiac arrest in selected patients.
KW - extracorporeal cardiopulmonary resuscitation
KW - organ donation
KW - out-of-hospital cardiac arrest
KW - LIFE-SUPPORT
U2 - 10.1111/ctr.70382
DO - 10.1111/ctr.70382
M3 - Article
SN - 0902-0063
VL - 39
JO - Clinical Transplantation
JF - Clinical Transplantation
IS - 11
M1 - e70382
ER -