Overview of traumatic cardiac arrest victims’ organ donation in France

Purpose: Organ donation is an issue which raises several ethical, economic and logistic aspects. In France, according to the law of August, 2nd 2005, a new source of organ donor was opened: Organ donations from patients deceased of cardiac arrest (ODDCA). Patients deceased following a traumatic cardiac arrest (TCA) are often targeted as potential donors. This study purpose is to characterize TCA deceased patients which are subjects of organ retrieval and to state if they really had all required criteria for theoretically been part of ODDCA program. 

Material and Methods: Descriptive national and multicentre study based on the French national cardiac arrest registry data gathered between 01/07/2011 and 01/01/2016.

Results: On 3898 TCA, 48 (1.2%) were subjects of organ retrieval. Among them, 13 (27.1%) were included as non-beating heart organ donors (donors deceased on scene) and 35 (72.9%) were included as brain-death donors (BDD). Median age of donors was 28 and 83.3% were male. Among the 13 ODDCA, 11 belonged to Maasticht class I and 2 to class II. Half of donors had isolated cranial trauma, 22 also had thoracic trauma and 2 had limb lesions. None had any comorbidity. Among 13 ODDCA, median time between CPR initiation and hospital admission was 66 minutes. Finally, 7 donors were younger than18 (1 ODDCA, 6 BDD) and 5 were older than 55 (1 ODDCA, 4 BDD).

Conclusion: Organ donation in TCA is almost as frequent as Day 30 survival in France. This frequency is even higher if compatibilized on organ donation compatible TCA. Globally, included patients matched requirements expect on age criterion. Taking patients profiles into account, these results should encourage professionals to keep this issue in mind while caring refractory cardiac arrests or post-resuscitation brain death occurrence.

Overview of traumatic cardiac arrest victims' organ donation in France