The feasibility of organ salvage from non-heart-beating trauma donors.

BACKGROUND

Blunt trauma patients without vital signs on admission are potential non-heart-beating donors.

OBJECTIVE

To review the feasibility of postmortem visceral perfusion and organ donation in blunt trauma patients without vital signs.

DESIGN

A retrospective case series of blunt trauma victims who were declared dead in the emergency department.

SETTING

A level I trauma center.

MAIN OUTCOME MEASURES: Factors potentially precluding donation and potential donor yield.

RESULTS

The mean trauma-to-death interval was 71 minutes (< 60 minutes in 57% of the cases). Injuries likely to interfere with in situ perfusion were present in 41% of the cases. The tissue donation consent rate was 45%. Assuming a similar organ donation consent rate, the potential donor yield was 9% after excluding victims who were younger than 60 years of age, warm ischemia times that were less than 60 minutes, and patients who had injuries precluding perfusion.

CONCLUSIONS

The potential organ yield from non-heart-beating, blunt trauma victims is low, which highlights the ethical and legal problems of this approach.