Organ Donor Potential After Extracorporeal Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest: A Post-Hoc Analysis of a Randomized Controlled Trial.
Verberght, H. C. R., et al.Clin Transplant. 2025 Nov;39(11):e70382.
Aims
The aim of this post-hoc study of the INCEPTION trial was to determine whether the use of extracorporeal cardiopulmonary resuscitation (ECPR) led to an increase in the number of potential organ donors after refractory out-of-hospital cardiac arrest (OHCA) in comparision to conventional cardiopulmonary resuscitation (CCPR).
Interventions
Participants were randomised to either the ECPR group or the CCPR group.
Participants
134 OHCA patients (aged 18 to 70 years)
Outcomes
The primary endpoint was the proportion of potential organ donors and the secondary endpoint was the proportion of potential liver and/or kidney donors.
Follow-up
N/A
CET Conclusions
The INCEPTION trial randomised patients experiencing out-of-hospital cardiac arrest (OHCA) to either conventional cardiopulmonary resuscitation (CCPR) or extra-corporeal CPR (ECPR). This post-hoc simulated study presented details of the randomised patients in a standardised format to transplant co-ordinators and physicians to assess potential suitability for organ donation. If two or more specialists deemed the patient potentially suitable, they were classified as having potential to donate. Intent-to-treat analysis showed more potential donors in the ECPR group (20% vs 6%). More donors were deemed suitable for liver donation than kidney donation. Whilst the study suggests the potential for ECPR use to improve donation rates, there are limitations. It does not appear that the transplant physicians assessing the potential for donation were blinded to the type of CPR used, which may introduce bias. It is also very likely that the potential for donation is overestimated, as many of the nuances of real-world offering are missing and clinicians are more likely to accept an offer in a simulated setting where there are no actual consequences
Trial registration
ClinicalTrials.gov-NCT03101787