The viability of transplanting organs from donors who underwent cardiopulmonary resuscitation: A systematic review.
West S, Soar J, et al.Resuscitation 2016; 108: 27-33.
Aims
This study aimed to identify reports of patients who underwent cardiopulmonary resuscitation (CPR) prior to solid organ donation and compare recipient and organ function outcomes to those that did not undergo CPR.
Interventions
A Systematic review of literature was conducted by searching full-text articles were on EMBASE, MEDLINE, Cochrane Database of Systematic Reviews and the Cochrane Register of Controlled Trials. Clinical studies comparing the outcome of patients and organs retrieved from donors who underwent CPR with those that did not require CPR were included.
Participants
Adult and paediatric organ transplantant recipients.
Outcomes
The primary outcome measure was immediate graft function,which was taken as up to 30 days post transplantation. Secondary outcomes were one year and five year graft function.
Follow-up
up to 5 years
CET Conclusions
This was a systematic review of observational studies comparing the outcomes of organs retrieved from donors who received CPR. The 22 included studies were divided into two groups: 1) Studies comparing DBD donors who received CPR with controls, 2) Studies comparing uncontrolled DCD with controls. As such there were only a few studies in each organ type. The authors quite rightly acknowledge that a great deal of heterogeneity is to be expected between these studies and meta-analysis was not considered to give useful additional information. The key confounder is that a difference in the number of organs considered unsuitable for transplantation following CPR significantly impacts the results. So, whilst this paper suggests that CPR in DBD donors has no significant impact on immediate organ function or graft survival (all organ types) this must be treated with considerable caution. Likewise, the lower rates of immediate function in kidney and liver transplantation following uncontrolled DCD may not be accurate when taking into account specific healthcare, donor and recipient factors.
Trial registration
None