Donation after circulatory death

Algahim, Mohamed F.; Love, Robert B.

doi:10.1097/mot.0000000000000179

Cited by 26 publications

(10 citation statements)

References 50 publications

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“…Although donation after cardiac death has been gradually increasing recently, DBD remains the main source of donor grafts in many countries at present3. It is generally accepted that the quality of grafts plays a crucial role in the transplantation outcome4. Particularly, compared to living-donor kidney transplantations, patients received kidneys from deceased donors have been shown to be of a significantly lower long-term patients and graft survival rate56.…”

mentioning

confidence: 99%

Ginkgo biloba extract EGb761 attenuates brain death-induced renal injury by inhibiting pro-inflammatory cytokines and the SAPK and JAK-STAT signalings

Xiong

Zhang

et al. 2017

Sci Rep

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This study aimed to investigate the protective effects of EGb761, a Ginkgo Biloba extract, against brain death-induced kidney injury. Sixty male Sprague Dawley rats were randomly divided into six groups: sham, brain-death (BD), BD + EGb b48h (48 hours before BD), BD + EGb 2 h (2 hours after BD), BD + EGb 1 h, and BD + EGb 0.5 h. Six hours after BD, serum sample and kidney tissues were collected for analyses. The levels of blood urea nitrogen (BUN) and serum creatinine significantly elevated in the BD group than in sham group. In all the EGb761-treated BD animals except for the BD + Gb 2 h group, the levels of BUN and serum creatinine significantly reduced (all P < 0.01). EGb761 attenuated tubular injury and lowered the histological score. In addition, the longer duration of drug treatment was, the better protective efficacy could be observed. EGb761 significantly reduced IL-1β, IL-6, TNF-α, MCP-1, IP-10 mRNA expression and macrophage infiltration in the kidney. EGb761 treatment at 48 hour before brain death significantly attenuate the levels of p-JNK-MAPK, p-p38-MAPK, and p-STAT3 proteins (all P < 0.05, compared to BD group). In summary, our data showed that EGb761 treatment protected donor kidney from BD-induced damages by blocking SAPK and JAK-STAT signalings. Early administration of EGb761 can provide better protective efficacy.

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confidence: 99%

Ginkgo biloba extract EGb761 attenuates brain death-induced renal injury by inhibiting pro-inflammatory cytokines and the SAPK and JAK-STAT signalings

Xiong

Zhang

et al. 2017

Sci Rep

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“…[10] Lungs are utilized from eligible multi-organ donors only 15–20% of the time, and few DCD lungs are procured and transplanted (< 2% of all lung transplants). [2] According to the United Network of Organ Sharing, organs were procured and transplanted from 1205 DCD donors in 2013, mostly organs other than lungs.…”

mentioning

confidence: 99%

Donation After Circulatory Death Lungs Transplantable Up to Six Hours After Ex Vivo Lung Perfusion

Charles

Huerter

Wagner

et al. 2016

The Annals of Thoracic Surgery

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Background Despite the critical need for donor lungs, logistical and geographical barriers hinder lung utilization. We hypothesized that donation after circulatory death (DCD) lungs subjected to 6-hours of cold preservation after ex vivo lung perfusion (EVLP) would have similar outcomes after transplantation compared to lungs transplanted immediately after EVLP, and both would perform superiorly compared with lungs transplanted immediately after procurement. Methods Donor porcine lungs were procured after circulatory death and 15-minutes of warm ischemia. Three groups (n=5/group) were randomized: immediate left lung transplantation (Immediate), EVLP for 4-hours followed by transplantation (EVLP), or EVLP for 4-hours followed by 6-hours of cold preservation followed by transplantation (EVLP+Cold). Lungs were reperfused for 2-hours prior to obtaining pulmonary vein samples for PaO2/FiO2 calculations, airway pressures for compliance measurements, and wet/dry weight ratios. Results PaO2/FiO2 ratios in EVLP and EVLP+Cold groups were significantly improved compared with the Immediate group (429.7±51.8 and 436.7±48.2 versus 117.4±22.9 mmHg, respectively). Additionally, dynamic compliance was significantly improved in the EVLP and EVLP+Cold groups compared to Immediate group (26.2±4.2 and 27.9±3.5 versus 11.1±2.4 mL/cmH2O, respectively). There were no differences in oxygenation capacity or dynamic compliance between EVLP and EVLP+Cold groups. Inflammatory cytokine levels were significantly lower in EVLP and EVLP+Cold groups. Conclusions DCD lungs can be successfully transplanted up to 6-hours after EVLP. Cold preservation of lungs following ex vivo assessment and rehabilitation may improve organ allocation, even to distant recipients, without compromising allograft function.

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“…Some studies pointed to positive results in transplants with DCD, even without the previous use of EVLP. ( 24 )…”

Section: Discussionmentioning

confidence: 99%

Evaluation and reconditioning of donor organs for transplantation through ex vivo lung perfusion

Abdalla¹,

Oliveira-Braga²,

Fernandes³

et al. 2019

Einstein (São Paulo)

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Objective: To assess the feasibility and impact of ex vivo lung perfusion with hyperoncotic solution (Steen Solution ™ ) in the utilization of these organs in Brazil. Methods: In this prospective study, we subjected five lungs considered to be high risk for transplantation to 4 hours of ex vivo lung perfusion, with evaluation of oxygenation capacity. High-risk donor lungs were defined by specific criteria, including inflammatory infiltrates, pulmonary edema and partial pressure of arterial oxygen less than 300mmHg (inspired oxygen fraction of 100%). Results: During reperfusion, the mean partial pressure of arterial oxygen (inspired oxygen fraction of 100%) of the lungs did not change significantly (p=0.315). In the first hour, the mean partial pressure of arterial oxygen was 302.7mmHg (±127.66mmHg); in the second hour, 214.2mmHg (±94.12mmHg); in the third hour, 214.4mmHg (±99.70mmHg); and in the fourth hour, 217.7mmHg (±73.93mmHg). Plasma levels of lactate and glucose remained stable during perfusion, with no statistical difference between the moments studied (p=0.216). Conclusion: Ex vivo lung perfusion was reproduced in our center and ensured the preservation of lungs during the study period, which was 4 hours. The technique did not provide enough improvement for indicating organs for transplantation; therefore, it did not impact on use of these organs.

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Donation after circulatory death

Abstract: In light of the continually growing disparity between organ supply and demand, DCD has regained traction as a means to increase the donor pool.

Cited by 26 publications

References 50 publications

Ginkgo biloba extract EGb761 attenuates brain death-induced renal injury by inhibiting pro-inflammatory cytokines and the SAPK and JAK-STAT signalings

Ginkgo biloba extract EGb761 attenuates brain death-induced renal injury by inhibiting pro-inflammatory cytokines and the SAPK and JAK-STAT signalings

Donation After Circulatory Death Lungs Transplantable Up to Six Hours After Ex Vivo Lung Perfusion

Evaluation and reconditioning of donor organs for transplantation through ex vivo lung perfusion

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