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Table 2 Summary of specific details of included guidelines and eligible outcome studies

From: Protocols for uncontrolled donation after circulatory death: a systematic review of international guidelines, practices and transplant outcomes

 

Death declaration

Time restrictions

Organ preservation

Ethical and legal issues addressed

Logistic issues

 

Definition of refractory cardiac arrest (time of CPR in min)

“No touch” time (min)

Max arrest time with no CPR (min)

Max time - CPR to cannulation (min)

Max time - cardiac arrest to cannulation (min)

Max time – cannulation to procurement (min)

Cannulation permitted prior to consent

n-ECMO used

h-ECMO used

In situ cooling

Pulsatile perfusion

Information given to next of kin on the field

Organ preservation initiated in ambulance during transport

Consent for cannulation of the cadaver for organ preservation

Objective of intra-aortic balloon

Health providers’ attitudes and beliefs

ECMO: organ preservation versus lifesaving technique

Cost-effectiveness evaluation

Coordination efforts needed

Guidelines (n = 6)

                   

France (2007) [30]

30 ACLS

5

30

90 mCPR 120 aCPR

120 mCPR 150 aCPR

180 ISC 240 ECMO

N

N

Y

Y

Y

Y

Y

Y

N

Y

N

N

Y

Italy; Pavia (2011) [34]

NS

20

15

110

125

360

N

Y

N

N

Y

N

Y

Y

N

N

N

Y

Y

Switzerland (2011) [32]

20

10

30

120

150

180

Y

Y

N

Y

N

N

N

N

N

N

N

N

N

US; New York City (2011) [4]

30

NS

NS

120

NS

240

N

Y

N

N

Y

Y

Y OPV

Y

Y

Y

Y

Y

Y

Spain; Alicante, Barcelona, Castilla La Mancha, Granada, Galicia, Madrid City and Region (2012) [31]

Failed CPR

5

15 A, C, Gr, M 20 Ga 30 B

120

150

120 ISC 240–360 ECMO

Y

Y A B C Gr M

Y M

Y A Ga Gr

Y B M

Y

Y

Y

Y

Y

N

Y

y

UK; Scotland (2013) [33]

Failed CPR

5

15

105

120

NS

Y

Y

N

N

Y

N

N

Y

Y

Y

N

Y

Y

Eligible outcome studies (n = 18)

                   

Gámez 2005 [13]/Spain, Madrid

30

5

15

105

120

240

Y

N

Y

Y

N

N

N

N

N

N

N

N

Y

Gagandeep 2006 [14]/USA, Nationwide

NS

NS

NS

NS

NS

NS

NS

NS

NS

NS

NS

NS

NS

NS

NS

NS

NS

Y

Y

Sánchez-Fructuoso 2006 [15]/Spain, Madrid

30

5

15

105

120

240

Y

N

Y

Y

Y

N

N

N

N

N

N

N

N

Fondevila 2007 [16]/Spain, Barcelona

NS

5

15

135

150

240

Y

Y

N

N

Y

N

N

Y

N

N

N

N

N

Suárez 2008 [17]/Spain, La Coruna

NS

5

15

105

120

240

Y

Y

Y

N

N

N

N

N

N

N

N

N

N

Fieux 2009 [18]/France, Paris

30 ACLS

5

30

90 mCPR 120 aCPR

120 mCPR 150 aCPR

180 ISC 240 ECMO

N

N

Y

Y

Y

Y

Y

Y

N

Y

N

N

Y

Gómez Gutierrez 2009 [19]/Spain, La Coruña and Madrid

Failed CPR

5

NS

NS

120

130

Y

Y

N

Y

N

N

N

N

N

Y

N

N

Y

Jiménez-Galanes 2009 [20]/Spain, Madrid

Failed CPR

5

15

135

150

240-270

Y

Y

N

N

NS

N

N

Y

N

N

N

N

Y

Ribalta 2009 [29]/Spain, Cataluña

Failed CPR

5

30

120

150

NS

Y

NS

NS

NS

Y

N

N

N

N

N

N

N

Y

Mateos-Rodríguez 2010 [21]/Spain, Madrid

Failed CPR

5

15

105

120

NS

Y

Y

NS

N

NS

N

N

N

N

N

Y

N

Y

Mateos-Rodríguez 2010 [22]/Spain, Madrid

30

5

15

105

120

240

Y

Y

N

NS

NS

N

N

N

N

N

Y

N

Y

Geraci and Sepe 2011 [34]/Italy, Pavia

NS

20

15

110

125

360

N

Y

N

N

Y

N

Y

Y

N

N

N

Y

Y

Hoogland 2011 [23]/The Netherlands, Maastricht

NS

5

NS

90

NS

NS

Y

N

N

Y

Y

N

N

Y

N

N

Y

N

Y

Rodríguez 2011 [24]/Spain, Madrid and Santander

NS

5

10

110

120

240

Y

N

N

Y

Y

N

N

N

N

N

N

N

N

Fondevila 2012 [25]/Spain, Barcelona

20

5

15

150

165

240

Y

Y

N

N

N

N

N

Y

N

N

N

Y

N

Gomez-de-Antonio 2012 [26]/Spain, Madrid

NS

5

15

105

120

240

Y

N

N

Y

Y after2009

N

N

N

N

N

N

N

N

Hanf 2012 [27]/France, Lyon

30

5

30

90 mCPR 120 aCPR

120 mCPR 150 aCPR

180

NS

Y

N

Y

Y

N

N

N

N

N

N

N

N

Reznick 2013 [28]/Russia, Saint Petersburg

Failed CPR

NS

60a

NS

NS

NS

Y

Y

N

N

NS

N

N

Y

N

N

Y

N

Y

  1. CPR cardiopulmonary resuscitation, n-ECMO normothermic extracorporeal membrane oxygenation, h-ECMO hypothermic extracorporeal membrane oxygenation, ECMO extracorporeal membrane oxygenation, ACLS advanced cardiac life support, mCPR manual cardiopulmonary resuscitation, aCPR automated cardiopulmonary resuscitation, ISC in situ cooling, OPV organ preservation vehicle, N the procedure is not used or the issue is not discussed, Y the procedure is used or issue is discussed, NS not specified (no information specified in guideline or study), A Alicante, C Castilla La Mancha, Gr Granada, M Madrid City and Region, Ga Galicia, B Barcelona
  2. atime is after failed CPR until Organ Procurement Organization arrival