biostudies-literatureUnknown12(1)Renaudier M<h4>Background</h4>Organ shortage is a major public health issue, and patients who die after out-of-hospital cardiac arrest (OHCA) could be a valuable source of organs. Here, our objective was to identify factors associated with organ donation after brain death complicating OHCA, in unselected patients entered into a comprehensive real-life registry covering a well-defined geographic area.<h4>Methods</h4>We prospectively analyzed consecutive adults with OHCA who were successfully resuscitated, but died in intensive care units in the Paris region in 2011-2018. The primary outcome was organ donation after brain death. Independent risk factors were identified using logistic regression analysis. One-year graft survival was assessed using Cox and log-rank tests.<h4>Results</h4>Of the 3061 included patients, 136 (4.4%) became organ donors after brain death, i.e., 28% of the patients with brain death. An interaction between admission pH and post-resuscitation shock was identified. By multivariate analysis, in patients with post-resuscitation shock, factors associated with organ donation were neurological cause of OHCA (odds ratio [OR], 14.5 [7.6-27.4], P < 0.001), higher pH (OR/0.1 increase, 1.3 [1.1-1.6], P < 0.001); older age was negatively associated with donation (OR/10-year increase, 0.7 [0.6-0.8], P < 0.001). In patients without post-resuscitation shock, the factor associated with donation was neurological cause of OHCA (OR, 6.9 [3.0-15.9], P < 0.001); higher pH (OR/0.1 increase, 0.8 [0.7-1.0], P = 0.04) and OHCA at home (OR, 0.4 [0.2-0.7], P = 0.006) were negatively associated with organ donation. One-year graft survival did not differ according to Utstein characteristics of the donor.<h4>Conclusions</h4>4% of patients who died in ICU after OHCA led to organ donation. Patients with OHCA constitute a valuable source of donated organs, and special attention should be paid to young patients with OHCA of neurological cause.Annals of intensive care48https://www.ebi.ac.uk/biostudies/studies/S-EPMC9170852biostudies-literatureOrgan donation after out-of-hospital cardiac arrest: a population-based study of data from the Paris Sudden Death Expertise Center.PMC9170852Lacotte JMaury EBillon CMarijon EMansouri NDomanski LExtramiana FBruel CFieux FDubois-Rande JLMegarbane BAlonso CMentec HPiot OLudes BNarayanan KFagon JYDuranteau JJouven XLavergne TTimsit JFAlla FDuboc DAlgalarrondo VDemoule ABinois YChaib ACasalino EMaxime VMira JPDumas FDinanian SLoeb TBruneval PMekontso-Dessap AAgostinucci JMSchortgen FLamhaut LDenjoy IKassim HPlu IRicard JDCharpentier JAzoulay ETuppin PCarli PFartoukh MLahlou-Laforet KVarenne OSideris GCohen YDreyfuss DVoicu SRichard CSharifzadehgan AGeri GLellouche NHenry PEmpana JPAdnet FLemoine FSharshar TKaram NTourtier JPAnnane DCoulaud JMRenaudier MDeye NMansencal NUrsat CCariou ALecarpentier ERevaux FHidden Lucet FLemiale VLinval FLuyt CEAntoine CJabre PSpaulding CRaux MLesieur OCombes AMonnet XRoussin FRaphalen JHLeenhardt ASantoli FGuidet BWaldmann VJost DBougouin WCrahes MMaltret ARiou BAmara WGandjbakhch ECerf CDas VPlaisance PCholley BLanceleur ANgoyi NPirracchio RHalimi FVieillard-Baron AParis Sudden Death Expertise Center groupDa Silva DBeganton FWahbi KGabbas MSimilowski TPerier MCMarty JJoseph LAubry PTeboul JLAissaoui-Balanant NLangeron ODiehl JLPlaud BBoutet JfalseOrgan donation after out-of-hospital cardiac arrest: a population-based study of data from the Paris Sudden Death Expertise Center.<h4>Background</h4>Organ shortage is a major public health issue, and patients who die after out-of-hospital cardiac arrest (OHCA) could be a valuable source of organs. Here, our objective was to identify factors associated with organ donation after brain death complicating OHCA, in unselected patients entered into a comprehensive real-life registry covering a well-defined geographic area.<h4>Methods</h4>We prospectively analyzed consecutive adults with OHCA who were successfully resuscitated, but died in intensive care units in the Paris region in 2011-2018. The primary outcome was organ donation after brain death. Independent risk factors were identified using logistic regression analysis. One-year graft survival was assessed using Cox and log-rank tests.<h4>Results</h4>Of the 3061 included patients, 136 (4.4%) became organ donors after brain death, i.e., 28% of the patients with brain death. An interaction between admission pH and post-resuscitation shock was identified. By multivariate analysis, in patients with post-resuscitation shock, factors associated with organ donation were neurological cause of OHCA (odds ratio [OR], 14.5 [7.6-27.4], P < 0.001), higher pH (OR/0.1 increase, 1.3 [1.1-1.6], P < 0.001); older age was negatively associated with donation (OR/10-year increase, 0.7 [0.6-0.8], P < 0.001). In patients without post-resuscitation shock, the factor associated with donation was neurological cause of OHCA (OR, 6.9 [3.0-15.9], P < 0.001); higher pH (OR/0.1 increase, 0.8 [0.7-1.0], P = 0.04) and OHCA at home (OR, 0.4 [0.2-0.7], P = 0.006) were negatively associated with organ donation. One-year graft survival did not differ according to Utstein characteristics of the donor.<h4>Conclusions</h4>4% of patients who died in ICU after OHCA led to organ donation. Patients with OHCA constitute a valuable source of donated organs, and special attention should be paid to young patients with OHCA of neurological cause.2022-01-01T00:00:00Z2022 Jun2024-11-21T07:08:15.839Z2024-11-21T07:08:15.839ZS-EPMC91708523566632310.1186/s13613-022-01023-7