Organ donation in trauma victims: a systematic review and meta-analysis

Background Although trauma patients represent a large pool of potential organ donors (PODs), the donor conversion rates (DCRs) in this population are unclear. Our primary objective was to synthesize published evidence on DCRs in trauma patients. As a secondary objective, we investigated factors that affect organ donation (OD) in the trauma population. Methods We searched four electronic databases (PubMed, Embase, Web of Science, Cochrane Library) and grey literature for articles on OD in trauma patients (PROSPERO 2017: CRD42017070388). Articles were excluded if it was not possible to calculate the DCR (actual organ donors divided by PODs). We pooled DCRs and performed subgroups analysis by trauma subpopulation, patient age, and study publication date. Results We identified 27 articles with a total of 123,142 participants. Cohorts ranged in size from 28 to 120,512 patients (median 132), with most studies performed in the United States. Conversion rates among individual studies ranged from 14.0% to 75.2% (median 49.3%). All 27 studies were included in the meta-analysis. We found a pooled DCR of 48.1% using the random effects model. There was a high level of heterogeneity between studies (I2 = 97.4%). Upon subgroup analysis, we found DCRs were higher in head trauma patients compared with traumatic cardiac arrest patients (45.3% vs. 20.9%, p

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