Estimating the Potential Pool of Uncontrolled DCD Donors in the United States

Brian J. Boyarsky; Kyle R. Jackson; Amber B. Kernodle; Joseph V. Sakran; Jacqueline M. Garonzik-Wang; Dorry L. Segev; Shane E. Ottmann

Disclosures

American Journal of Transplantation. 2020;20(10):2842-2846. 

In This Article

Results

Between 2013 and 2016, there were on average 26 941 (range: 26 063–28 746) refractory cardiac arrests in EDs nationwide (Figure 1). We excluded 13 134 (range 12 381–13 799) patients who were >55 years old. We then excluded 1730 (range: 849–2363) patients with any medical contraindication to donation (including infection, cardiorespiratory, allergy, autoimmune, metabolic, gastrointestinal, hematologic-oncologic, vascular, and pregnancy). We then excluded 2248 patients (range: 1513–2983) with specific contraindications to uDCD (including hemorrhage, major polytrauma, fire, poisoning, adverse medication effect, and toxic ingestion). This left 9828 (range: 9454–10 202) potential uDCD donors who met our eligibility criteria. Trauma accounted for 91.1% of deaths (n = 8953).

Among these potential donors, the average age was 32.2 ± 0.16 years and 77.9% were male. Regarding age, 46.6% of patients were <30 years old, 39.7% were 30–49 years old, and 13.7% were 50–55 years old. The major causes of death were blunt, nonhead trauma (43.2%), and head trauma (40.1%). Potential donors were largely evenly distributed across the United States, with a slightly higher proportion coming from the South (39.6%) versus other areas; 92.6% of hospitals were in urban areas and 71.3% of hospitals were designated as Level 1, 2, or 3 trauma centers; 76.5% of hospitals were teaching hospitals.

Figure 1.

Eligibility criteria for potential uncontrolled DCD organ donors identified in the NEDS between January 1, 2013 and December 31, 2016. Estimates are presented as the average number of potential donors per year and weighted per NEDS (Nationwide Emergency Department Sample); DCD, donation after circulatory death

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