Prehospital presentation of organ donors – a registry-based cohort study.

Abstract Introduction: There may be an unrealised prehospital potential for procuring organ donors. The objective of this study was to characterise the prehospital patients who underwent organ donation to alert prehospital physicians to patients who may potentially increase the donor pool.Methods: This is a retrospective register-based study from the Region of Southern Denmark. The prehospital medical records from patients who underwent organ donation after prehospital care from 1st of January 2016 – 31st of December 2020 were screened for inclusion. The Outcome measures were prehospital diagnosis, vital parameters, and critical interventions.Results: In the five year period, one-hundred-and-fifty-one patients were entered into a donation process in the health region following prehospital care. Sixteen patients were excluded due to limitations in data availability (transfer from hospitals outside of the health region or transport by helicopter). Of the 135 patients in the study, forty-nine patients had a stroke. One-third of these patients were intubated prehospitally. Twenty-one patients had subarachnoideal haemorrhage. Two-thirds of these were intubated prehospitally. Fourteen patients suffered from head trauma. One-third of these patients were intubated at the scene. In 29 patients, the prehospitally assigned tentative diagnosis was missing or included a diverse spectrum of medical and surgical emergencies.Twenty-two patients (16.3%) were resuscitated from cardiac arrest.Conclusion: The majority of the patients who were entered into an organ donation process presented prehospitally with intracranial pathology. However, 30% of patients were assigned other diagnoses not related to intracranial pathology. Among these, one patient in six had out-of-hospital cardiac arrest. There is a potential for enlarging the donor pool if the decision processes in out-of-hospital cardiac arrest include considerations concerning the procurement of organ donors.Trial Registration: N/A