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Enhancing the Tissue Donor Pool through Donation after Death in the Field

Published online by Cambridge University Press:  22 January 2013

Adam M. Shiroff ,
Stephen C. Gale ,
Mark A. Merlin ,
Jessica S. Crystal ,
Matt Linger ,
Anar D. Shah ,
Erin Beaumont ,
Elie Lustiger ,
Erica Tabakin  and
Vicente H. Gracias
Adam M. Shiroff
Affiliation:
Department of Surgery, Division of Acute Care Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey USA .
Stephen C. Gale*
Affiliation:
Department of Surgery, Division of Acute Care Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey USA .
Mark A. Merlin
Affiliation:
Department of Surgery, Division of Acute Care Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey USA .
Jessica S. Crystal
Affiliation:
Department of Surgery, Division of Acute Care Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey USA .
Matt Linger
Affiliation:
Department of Surgery, Division of Acute Care Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey USA .
Anar D. Shah
Affiliation:
Department of Surgery, Division of Acute Care Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey USA .
Erin Beaumont
Affiliation:
Department of Surgery, Division of Acute Care Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey USA .
Elie Lustiger
Affiliation:
Department of Surgery, Division of Acute Care Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey USA .
Erica Tabakin
Affiliation:
Department of Surgery, Division of Acute Care Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey USA .
Vicente H. Gracias
Affiliation:
Department of Surgery, Division of Acute Care Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey USA .
*
Correspondence: Stephen C. Gale, MD Department of Surgery UMDNJ-Robert Wood Johnson Medical School 89 French St 3rd Floor CHI New Brunswick, NJ 08901 USA E-mail galest@umdnj.edu
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Abstract

Introduction

Tissue transplantation is an important adjunct to modern medical care and is used daily to save or improve patient lives. Tissue allografts include bone, tendon, corneas, heart valves and others. Increasing utilization may lead to tissue shortages, and tissue procurement organizations continue to explore ways to expand the cadaveric donor pool. Currently more than half of all deaths occur outside the acute care setting.

Hypothesis

Many who suffer prehospital deaths might be eligible for non-organ tissue donation.

Methods

A retrospective review of electronic prehospital medical records was conducted from May 1, 2008 through December 31, 2009. All prehospital deaths were included irrespective of cause. Once identified, additional medical history was obtained from prehospital, inpatient, and emergency department records. Age, medical history, and time of death were compared to exclusion criteria for four tissue procurement organizations (MTF, LifeNet, LifeCell, EyeBank). After analysis, percentages of eligible donors were calculated.

Results

Over 50,000 prehospital records were reviewed; 432 subjects died in the field and were eligible for analysis. Ages ranged from four to 103 years of age; the average was 68.3 (SD = 20.1) years. After exclusion for age, medical conditions, and time of death, 185 unique patients (42.8%) were eligible for donation to at least one of the four tissue procurement organizations (range 11.6%-34.3%).

Conclusions

After prehospital death, many individuals may be eligible for tissue donation. These findings suggest that future prospective studies exploring tissue donation after prehospital death are indicated. These studies should aim to clarify eligibility criteria, create protocols and infrastructure, and explore the ethical implications of expanding tissue donation to include this population.

ShiroffAM, GaleSC, MerlinMA, CrystalJS, LingerM, ShahAD, BeaumontE, LustigerE, TabakinE, GraciasVH. Enhancing the Tissue Donor Pool through Donation after Death in the Field. Prehosp Disaster Med. 2013;28(2):1-4.

Keywords

prehospital deathtissue donationtransplantation
Type
Brief Report
Information
Prehospital and Disaster Medicine , Volume 28 , Issue 2 , April 2013 , pp. 187 - 190
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2013

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Footnotes

Drs. Shiroff and Gale made equal contributions to the first author role

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