Use of the Lucas mechanical chest compression device in an asystolic organ donation program: effect on kidney perfusion and organ procurement and transplantation rate

Carmona Jiménez F, Ruiz Arránz Á, Palma Padró P, Soto García À, Alberola Martín M, Saavedra Escobar S

Objective: To analyze whether using the Lucas mechanical chest compression device

while transporting potential non–heart-beating donors to the hospital has an effect on

kidney perfusion and the number of kidneys procured and transplanted.

Methods: Retrospective and prospective study of cases between January 2006 and

January 2010. Data reflected 2 phases: before introduction of the Lucas device in

February 2008 and afterwards. We analyzed the effect on our asystolic organ donor

program by comparing the results in non–heart-beating donor candidates (type 2

according to the Maastricht classification) transported under manual cardiopulmonary

resuscitation (CPR) or mechanical compressions. Variables recorded were age, sex, body

mass index, CPR or mechanical compression times, reasons for not procuring donated

organs, and organs procured and transplanted or rejected because of poor perfusion.

Data were extracted from the records of the transplant coordination unit of Hospital

Clínic de Barcelona.

Results: Of 203 cardiac-death donor candidates, 112 were transported with manual CPR

and 91 with compressions delivered by the Lucas device. The mean (SD) age of

candidates was 46.6 (13.1) years and 84.2% were men. The age and sex distribution in

the 2 time periods did not differ significantly (P=.86). In the manual CPR period 33% of

the candidates (n=37) became donors, whereas 37.4% (n=34) became donors in the

mechanical compression period (P=.52). Surgeons extracted 97.3% (n=72) of the

kidneys in the first period and 100% (n=68) in the second period (P=.34). Use of the

Lucas device was associated with an increase of 0.3 transplanted kidneys per donor

(95% CI, –0.1 to 0.7) (P=.166) and a decrease of 32.9% in kidneys rejected because of

poor perfusion (95% CI, 3.8% to 56.6%) (P=.026).

Conclusions: Using the Lucas chest compression device helps maintain the rate of

transplanted kidneys and even tends to increase the rate slightly. After beginning to use

mechanical compression, we observed a significant decrease in the percentage of

kidneys rejected for poor perfusion.

Alberola Martín M, Carmona Jiménez F, Palma Padró P, Ruiz Arránz Á, Saavedra Escobar S, Soto García À