242.2: Similar 1-year organ function from controlled donation after circulatory death using normo-thermic regional perfusion and donation after brain death.

Foss, Stein; Nordheim, Espen; Hagness, Morten; Sørensen, Dag Wendelbo; Syversen, Torgunn Bø; Midtvedt, Karsten; Åsberg, Anders; Dahl, T; Storrø, M. O.; Fiane, Arnt Espen; Line, Pål-Dag

doi:10.1097/01.tp.0000611828.58341.c7

Cited by 1 publication

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“…Table 1 summarizes heparin administration practices across studies involving liver, 19-49 kidney, 25,28,36,41,48,50-62 lung, 25,48,61,63-68 pancreatic, 69 simultaneous pancreas and kidney, 25,69-72 pancreas after kidney, 69 and simultaneous liver and kidney 73 transplantation.…”

Section: Resultsmentioning

confidence: 99%

Antemortem Heparin in Organ Donation After Circulatory Death Determination: A Systematic Review of the Literature

et al. 2021

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Donation after circulatory death determination frequently involves antemortem heparin administration to mitigate peri-arrest microvascular thrombosis. We systematically reviewed the literature to: (1) describe heparin administration practices and (2) explore the effects on transplant outcomes. We searched MEDLINE and EMBASE for studies reporting donation after circulatory death determination heparin practices including use, dosage, and timing (objective 1). To explore associations between antemortem heparin and transplant outcomes (objective 2), we (1) summarized within-study comparisons and (2) used meta-regression analyses to examine associations between proportions of donors that received heparin and transplant outcomes. We assessed risk of bias using the Newcastle Ottawa Scale and applied the GRADE methodology to determine certainty in the evidence. For objective 1, among 55 eligible studies, 48 reported heparin administration to at least some donors (range: 15.8%-100%) at variable doses (up to 1000 units/kg) and times relative to withdrawal of life-sustaining therapy. For objective 2, 7 studies that directly compared liver transplants with and without antemortem heparin reported lower rates of primary nonfunction, hepatic artery thrombosis, graft failure at 5 y, or recipient mortality (low certainty of evidence). In contrast, meta-regression analysis of 32 liver transplant studies detected no associations between the proportion of donors that received heparin and rates of early allograft dysfunction, primary nonfunction, hepatic artery thrombosis, biliary ischemia, graft failure, retransplantation, or patient survival (very low certainty of evidence). In conclusion, antemortem heparin practices vary substantially with an uncertain effect on transplant outcomes. Given the controversies surrounding antemortem heparin, clinical trials may be warranted.

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