Controlled donation after circulatory death (cDCD) in post-anoxic brain injury is a valuable source of organs that is still underused in some countries. We assessed the number of potential cDCD donors after out-of-hospital cardiac arrest (OHCA) in Paris and its suburbs and extrapolated the results to the French population. Using the large regional registry of the Great Paris area, we prospectively included all consecutive adults with OHCA with a stable return of spontaneous circulation (ROSC) who ultimately died in the intensive care unit (ICU) after withdrawal of life-sustaining treatments (WLST) due to post anoxic brain injury. The primary endpoint was potential for organ donation by cDCD in this population. The number of potential cDCD donors was calculated and extrapolated to the entire French population. Between 2011 and 2018, 4638 patients with stable ROSC were admitted to ICUs after OHCA, and 3170 died in ICU, of which 1034 died after WLST due to post-anoxic brain injury. When considering French criteria, 421/1034 patients (41%) would have been potential cDCD donors (55 patients per year in a 4.67 million population). After standardization for age and sex, the potential for cDCD was 515 (95% CI 471–560) patients per year in France corresponding to an annual incidence of 1.18 per 100 000 inhabitants per year. Organ donation by cDCD after cardiac arrest could provide a large pool of donors in France.

中文翻译：

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心脏骤停后患者循环死亡后的控制性捐赠：来自大型登记处的估计


缺氧性脑损伤后循环死亡后的控制性捐献（cDCD）是一种宝贵的器官来源，但在一些国家仍未得到充分利用。我们评估了巴黎及其郊区院外心脏骤停 (OHCA) 后潜在的 cDCD 捐赠者的数量，并将结果外推到法国人口。利用大巴黎地区的大型区域登记，我们前瞻性地纳入了所有连续患有 OHCA 且自主循环稳定恢复 (ROSC) 且在停止生命维持治疗 (WLST) 后最终死于重症监护室 (ICU) 的成年人由于缺氧性脑损伤后。主要终点是 cDCD 在该人群中进行器官捐献的可能性。潜在的 cDCD 捐赠者数量经过计算并外推至整个法国人口。 2011年至2018年间，4638例ROSC稳定的患者在OHCA后入住ICU，3170例在ICU死亡，其中1034例在WLST后因缺氧性脑损伤死亡。考虑法国标准时，421/1034 名患者 (41%) 可能是潜在的 cDCD 捐赠者（467 万人口中每年 55 名患者）。在年龄和性别标准化后，法国每年有 515 名 cDCD 患者（95% CI 471-560），相当于每年每 10 万居民 1.18 例。心脏骤停后 cDCD 的器官捐献可为法国提供大量捐献者。