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The commonest bedside objection to donation after a failed ECPR run - that prolonged resuscitation has ruined the organs - is not supported. Organs from resuscitated donors performed comparably at longest follow-up. The donation pathway matters more than the resuscitation that preceded it.
Donors who did not receive resuscitation; and uncontrolled circulatory-death against brain-death pathways
DOI 10.1016/j.resuscitation.2025.110654
Solid organ donation from donors who underwent cardiopulmonary resuscitation before death
Observational studies throughout, with heterogeneous definitions of resuscitation exposure and variable follow-up. Structured abstract only. [VERIFICATION REQUIRED]
In 24 studies comparing brain-dead donors with and without preceding resuscitation, graft outcomes did not differ for any organ. Uncontrolled donation after circulatory death against donation after brain death showed lower long-term liver graft survival (OR 0.51, 0.32-0.83) and lower short-term but not long-term kidney survival (OR 0.64, 0.36-1.15). Two studies comparing controlled with uncontrolled circulatory-death kidneys found no difference in long-term survival (OR 0.73, 0.27-1.99).
33 studies, 72,994 donors (26 studies in adults), searched to January 2025