Journal article
The Impact of Therapeutic Hypothermia Used to Treat Anoxic Brain Injury After Cardiopulmonary Resuscitation on Organ Donation Outcomes
Therapeutic hypothermia and temperature management, Vol.9(4), pp.258-264
12/2019
DOI: 10.1089/ther.2018.0043
PMID: 30848704
Abstract
Therapeutic hypothermia (TH) is clinically used to improve neurologic outcomes in patients with anoxic brain injury after cardiopulmonary resuscitation (CPR). For patients that regress and become organ donors after neurologic determination of death (DNDDs), the impact of TH received before determination of death on organ donation outcomes remains unknown. A prospective observational study of all adult DNDDs that received CPR and had anoxia as a cause of death from March 2013 to December 2014 was conducted across 20 organ procurement organizations (OPOs) in the United States. Main outcome measures included organs transplanted per donor (OTPD), specific organ transplantation rates, and recipient graft outcomes. One thousand ninety eight DNDDs met inclusion criteria, with 46% having received TH before determination of death. DNDDs with hypothermia before death had a similar number of OTPD (2.74 vs. 2.69,
= 0.61) and similar transplantation rates of individual organs. With regards to recipients, there was significantly less delayed graft function (DGF) in kidney grafts from donors who received TH before death (24% vs. 30%,
= 0.02). After adjusting for donor, recipient, and graft related factors, the protective effect of TH on DGF persisted (OR 0.75, 95%CI [0.56-0.995],
= 0.046). TH before death in the donor is independently associated with a 25% decrease in DGF among kidney recipients. This should be considered a protective donor selection factor in guiding the decision to accept or reject an organ for transplantation.
Details
- Title: Subtitle
- The Impact of Therapeutic Hypothermia Used to Treat Anoxic Brain Injury After Cardiopulmonary Resuscitation on Organ Donation Outcomes
- Creators
- Charles Wright - Link FoundationMadhukar S Patel - Massachusetts General HospitalXiang Gao - University of IowaMaxwell Witt - University of MichiganMitchell Sally - Portland VA Medical CenterTahnee Groat - Portland VA Medical CenterMegan Crutchfield - Oregon Health & Science UniversityNikole Neidlinger - Donor Network WestMarkeith Pilot - OneLegacy, Los Angeles, CaliforniaDarren J Malinoski - Oregon Health & Science UniversityOrgan Donation Research Consortium (ODRC) Anoxic Organ Donor Study Group
- Resource Type
- Journal article
- Publication Details
- Therapeutic hypothermia and temperature management, Vol.9(4), pp.258-264
- DOI
- 10.1089/ther.2018.0043
- PMID
- 30848704
- NLM abbreviation
- Ther Hypothermia Temp Manag
- ISSN
- 2153-7658
- eISSN
- 2153-7933
- Language
- English
- Date published
- 12/2019
- Academic Unit
- Surgery
- Record Identifier
- 9985016422602771
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