Donation after circulatory death - an expanded opportunity for donation appreciated by families

Syversen, Torgunn Bø; Sørensen, Dag Wendelbo; Foss, Stein; Andersen, Marit Helen

doi:10.1016/j.jcrc.2017.09.002

Cited by 7 publications

(2 citation statements)

References 33 publications

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“…We have previously published results on the importance of careful planning, good practices, and attention to individual needs for both the patients and their families. 20 Our results found that bereaved families of cDCD donors where NRP are used to demonstrate an overall positive experience during the different phases of the donation process. 20 …”

Section: Discussionmentioning

confidence: 57%

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First Scandinavian Protocol for Controlled Donation After Circulatory Death Using Normothermic Regional Perfusion

Foss

Nordheim

Sørensen

et al. 2018

Transplantation Direct

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BackgroundDonation after circulatory death (DCD) can increase the pool of available organs for transplantation. This pilot study evaluates the implementation of a controlled DCD (cDCD) protocol using normothermic regional perfusion in Norway.MethodsPatients aged 16 to 60 years that are in coma with documented devastating brain injury in need of mechanical ventilation, who would most likely attain cardiac arrest within 60 minutes after extubation, were eligible. With the acceptance from the next of kin and their wish for organ donation, life support was withdrawn and cardiac arrest observed. After a 5-minute no-touch period, extracorporeal membrane oxygenation for post mortem regional normothermic regional perfusion was established. Cerebral and cardiac reperfusion was prevented by an aortic occlusion catheter. Measured glomerular filtration rates 1 year postengraftment were compared between cDCD grafts and age-matched grafts donated after brain death (DBD).ResultsEight cDCD were performed from 2014 to 2015. Circulation ceased median 12 (range, 6-24) minutes after withdrawal of life-sustaining treatment. Fourteen kidneys and 2 livers were retrieved and subsequently transplanted. Functional warm ischemic time was 26 (20-51) minutes. Regional perfusion was applied for 97 minutes (54-106 minutes). Measured glomerular filtration rate 1 year postengraftment was not significantly different between cDCD and donation after brain death organs, 75 (65-76) vs 60 (37-112) mL/min per 1.73 m2 (P = 0.23). No complications have been observed in the 2 cDCD livers.ConclusionA protocol for cDCD is successfully established in Norway. Excellent transplant outcomes have encouraged us to continue this work addressing the shortage of organs for transplantation.

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Section: Discussionmentioning

confidence: 57%

“… 20 Our results found that bereaved families of cDCD donors where NRP are used to demonstrate an overall positive experience during the different phases of the donation process. 20 …”

Section: Discussionmentioning

confidence: 57%