Organ Donation from Patients Receiving Extracorporeal Membrane Oxygenation: A Systematic Review
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.
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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