https://hdl.handle.net/10807/200 2026-06-02T20:45:25Z https://hdl.handle.net/10807/337561 Titolo: Does cardiopulmonary resuscitation before donor death affect solid organ transplant function? A systematic review and meta-analysis Autori: Sandroni C.; Scquizzato T.; Cacciola S.; Bonizzoni M. A.; West S.; D'Arrigo S.; Soar J. Abstract: Introduction: Patients who die after cardiopulmonary resuscitation (CPR) are an important source of solid organs, but ischaemia–reperfusion injury may lead to worse recipient outcomes. This systematic review and meta-analysis assessed if solid organs transplanted from donors who underwent CPR had worse outcomes compared to organs from donors who did not receive CPR. Methods: PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched until January 1, 2025. The primary outcome (graft survival at the longest follow-up) and secondary outcomes (30-day and 1-year graft survival) were calculated separately for each organ and pathway (brain/circulatory death). Results: We included 33 studies (26 in adults; 72,994 donors), of which three compared multiple organs and pathways. In 24 studies comparing brain-dead donors with vs without CPR in all organs, outcomes did not differ between groups. In nine studies, donation after uncontrolled circulatory death compared to donation after brain death showed a lower long-term survival for livers (OR 0.51 [0.32–0.83]) and lower short-term but not long-term survival (OR 0.64[0.36–1.15]) for kidneys. Two studies in kidneys compared donation in controlled vs uncontrolled circulatory death showing no different long-term survival (OR 0.73[0.27–1.99]). Conclusions: Organs transplanted from donors who received CPR demonstrated comparable outcomes at the longest follow-up compared to organs from donors who did not receive CPR. Kidneys and livers after uncontrolled donation after circulatory death showed worse outcomes compared to donation after brain death. 2025-01-01T00:00:00Z https://hdl.handle.net/10807/337560 Titolo: European Resuscitation Council Guidelines 2025 Executive Summary Autori: Greif R.; Lauridsen K. G.; Djarv T.; Ek J. E.; Monnelly V.; Monsieurs K. G.; Nikolaou N.; Olasveengen T. M.; Semeraro F.; Spartinou A.; Yeung J.; Baldi E.; Biarent D.; Djakow J.; van Gils M.; van Goor S.; Grasner J. -T.; Hogeveen M.; Karageorgos V.; Lott C.; Madar J.; Nabecker S.; de Raad T.; Raffay V.; Rogers J.; Sandroni C.; Schnaubelt S.; Smyth M. A.; Soar J.; Wittig J.; Perkins G. D.; Nolan J. P. Abstract: The 2025 European Resuscitation Council (ERC) Guidelines present the most up-to-date evidence-based guidelines for the practice of resuscitation across Europe. The ERC Guidelines 2025 are based on evidence produced by the International Liaison Committee on Resuscitation (ILCOR) in the form of systematic reviews, scoping reviews, and evidence updates, published as the ILCOR Consensus on Science with Treatment Recommendations. The certainty of evidence of these ILCOR treatment recommendations was used to issue the ERC Guidelines 2025 Recommendations. In some cases, the ERC made good practice statements when evidence was absent for certain topics. If no ILCOR review was available, the ERC writing groups conducted their own reviews to provide recommendations. The ERC Guidelines 2025 cover the epidemiology of cardiac arrest, the role that systems play in saving lives, adult basic life support, adult advanced life support, resuscitation in special circumstances, post resuscitation care, newborn resuscitation and support of transition of infants at birth, paediatric basic and advanced life support, resuscitation ethics, education for resuscitation, and first aid. These guidelines are a framework of recommendations for the approach to out-of-hospital and in-hospital resuscitation; the implementation is achieved locally taking local legislation and health care regulations into consideration. 2025-01-01T00:00:00Z https://hdl.handle.net/10807/337559 Titolo: Methodology and Conflict of Interest Management: 2025 International Liaison Committee on Resuscitation Consensus on Science With Treatment Recommendations Autori: Morley P. T.; Berg K. M.; Billi J. E.; Nolan J. P.; Montgomery W. H.; Atkins D. L.; Bray J. E.; Carlson J. N.; de Caen A. R.; Djarv T.; Drennan I. R.; Greif R.; Lavonas E. J.; Liley H. G.; Lockey A. S.; Maconochie I.; Neumar R. W.; Olasveengen T. M.; Orkin A. M.; Perkins G. D.; Rabi Y.; Sandroni C.; Schmolzer G. M.; Scholefield B. R.; Singletary E. M.; Welsford M.; Yeung J.; Morrison L. J. 2025-01-01T00:00:00Z https://hdl.handle.net/10807/337558 Titolo: Effects of withdrawal of life-sustaining therapy on long-term neurological outcome after cardiac arrest − A multicentre matched cohort study Autori: Lagebrant A.; Lee B. K.; Youn C. S.; Sandroni C.; Belohlavek J.; Cariou A.; Carrai R.; Dankiewicz J.; Friberg H.; Grejs A. M.; Grippo A.; Hassager C.; Horn J.; Haenggi M.; Jakobsen J. C.; Keeble T. R.; Kirkegaard H.; Kjaergaard J.; Kuiper M. A.; Lee D. H.; Levin H.; Lilja G.; Lundin A.; Nielsen N.; Oddo M.; Oh S. H.; Park K. N.; Pellis T.; Robba C.; Rylander C.; Ryu S. J.; Saxena M.; Scarpino M.; Schrag C.; Stammet P.; Storm C.; Taccone F. S.; Thomas M.; Ullen S.; Westhall E.; Wise M. P.; Young P.; Cronberg T.; Moseby-Knappe M. Abstract: Purpose: To assess the risk of self-fulfilling prophecy from withdrawal of life-sustaining therapy (WLST) in comatose cardiac arrest patients undergoing neuroprognostication. Methods: Post-hoc multicentre study matching adults resuscitated from out-of-hospital cardiac arrests, in WLST-permitting cohorts (TTM and TTM2), and non-WLST-permitting cohorts (KORHN and ProNeCA). We matched patients in a 1:1 ratio based on a propensity score, assessing the risk of WLST due to a presumed poor neurological prognosis and criteria predictive of poor neurological outcome, as outlined in the 2021 European Resuscitation Council/European Society of Intensive Care Medicine (ERC/ESICM) guidelines. Functional outcome was compared at six months. Results: We included 1717 patients, of whom 497 (29 %) had WLST due to neurological criteria at a median of 143 h (IQR 108–177). 303 (61 %) patients with WLST retrospectively fulfilled ≥ 2 ERC/ESICM criteria predictive of poor outcome. No patients with ≥ 2 ERC/ESICM criteria had good functional outcome at six months, neither in the WLST cohort nor among the matched controls. One patient (0.3 %) with an indeterminate prognosis (≤1 ERC/ESICM criteria) had a good functional outcome in the WLST cohort versus 18–26 % of the matched controls. In exploratory weighted estimates, up to 18 % of patients with indeterminate prognosis may have survived with a good functional outcome, if WLST had not occurred. Conclusion: In patients with at least 2 ERC/ESICM criteria predictive of poor outcome, the risk of self-fulfilling prophecy from WLST was negligible. However, in patients with an indeterminate prognosis, the practice of WLST was associated with a lower likelihood of good functional outcome. 2025-01-01T00:00:00Z