Potential for organ donation after controlled circulatory death: a retrospective analysis

Autores da FMUP

• António De Almeida E Sousa Cardoso Fernandes

  Autor

• Ana Marta Matos Silva

  Autor

• Roberto Liberal Fernandes Roncon Albuquerque

  Autor

• José Artur Osório De Carvalho Paiva

  Autor

Participantes de fora da FMUP

• Dias, FS
• Fernandes, DM
• Bas?lio, C
• Gatta, N

Unidades de investigação

• Cirurgia e Fisiologia

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• Medicina

• Medicina da Comunidade, Informação e Decisão em Saúde

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Objectives:</jats:title> <jats:p>Despite the discrepancy between demand and availability of organs for transplantation, controlled circulatory death donation has not been implemented in Portugal. This study aimed to estimate the potential increase in organ donation from implementing such a program.</jats:p> </jats:sec> <jats:sec> <jats:title>Material and Methods:</jats:title> <jats:p>All deceased patients within the intensive care medicine department at Centro Hospitalar Universit?rio de S?o Jo?o, throughout the year 2019, were subjected to retrospective analysis. Potential gain was estimated comparing the results with the number of donors and organs collected during the same period at this hospital center. Differences in variables between groups were assessed using <jats:italic toggle="yes">t</jats:italic> tests for independent samples or Mann?Whitney <jats:italic toggle="yes">U</jats:italic> tests for continuous variables, and chi-squared tests were used for categorical variables.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>During 2019, 152 deaths occurred after withdrawal of life-sustaining therapies, 10 of which would have been potentially eligible for donation after controlled circulatory death. We can anticipate a potential increase of 10 prospective donors, a maximum 21% growth in yearly transplantation activity, with a greater impact on kidney transplantation. For most patients, the time between withdrawal of organ support and death surpassed 120 minutes, an outcome explained by variations in withdrawal of life-sustaining measures and insufficient clinical records, underestimating the potential for controlled circulatory arrest donation.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion:</jats:title> <jats:p>This study effectively highlights public health benefits of controlled circulatory arrest donation. Legislation allowing donation through this method represents a social gain and enables patients who will never meet brain death criteria to donate organs as part of the end-of-life process in intensive care medicine, within a framework of complete ethical alignment.</jats:p> </jats:sec>