Organ Donation from Patients Receiving Extracorporeal Membrane Oxygenation: A Systematic Review

Sasa Rajsic; Benedikt Treml; Nicole Innerhofer; Christine Eckhardt; Aleksandra Radovanovic Spurnic; Robert Breitkopf

doi:10.1053/j.jvca.2024.03.020

Organ Donation from Patients Receiving Extracorporeal Membrane Oxygenation: A Systematic Review

J Cardiothorac Vasc Anesth. 2024 Mar 20:S1053-0770(24)00188-5. doi: 10.1053/j.jvca.2024.03.020. Online ahead of print.

Authors

Sasa Rajsic¹, Benedikt Treml², Nicole Innerhofer², Christine Eckhardt², Aleksandra Radovanovic Spurnic³, Robert Breitkopf²

Affiliations

¹ Department of Anesthesiology and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria. Electronic address: sasa.rajsic@i-med.ac.at.
² Department of Anesthesiology and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria.
³ Clinic for Infectious and Tropical Diseases, University Clinical Centre of Serbia, Belgrade, Serbia.

PMID: 38643059
DOI: 10.1053/j.jvca.2024.03.020

Abstract

Objective: The mismatch between the demand for and supply of organs for transplantation is steadily growing. Various strategies have been incorporated to improve the availability of organs, including organ use from patients receiving extracorporeal membrane oxygenation (ECMO) at the time of death. However, there is no systematic evidence of the outcome of grafts from these donors.

Design: Systematic literature review (Scopus and PubMed, up to October 11, 2023).

Setting: All study designs.

Participants: Organ recipients from patients on ECMO at the time of death.

Intervention: Outcome of organ donation from ECMO donors.

Measurements and main results: The search yielded 1,692 publications, with 20 studies ultimately included, comprising 147 donors and 360 organ donations. The most frequently donated organs were kidneys (68%, 244/360), followed by liver (24%, 85/360). In total, 98% (292/299) of recipients survived with a preserved graft function (92%, 319/347) until follow-up within a variable period of up to 3 years.

Conclusion: Organ transplantation from donors supported with ECMO at the time of death shows high graft and recipient survival. ECMO could be a suitable approach for expanding the donor pool, helping to alleviate the worldwide organ shortage.

Keywords: ECLS; ECMO; eCPR; extracorporeal cardiopulmonary resuscitation; extracorporeal life support; extracorporeal membrane oxygenation; organ donation; transplantation.