Mobile Extracorporeal Membrane Oxygenation Teams for Organ Donation After Circulatory Death

Figini, Maria Adele; Paredes-Zapata, David; Juan, Eva Oliver; Chiumello, Davide

doi:10.1016/j.transproceed.2020.02.045

Cited by 7 publications

(2 citation statements)

References 25 publications

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“…In some countries, NRP can only be performed in designated hospitals. Mobile NRP teams, using portable devices, have also been piloted (Table S3) [52]. Mobile teams require close collaboration with the donor hospital.…”

Section: Minimal Logistic Requirements For Nrpmentioning

confidence: 99%

Consensus statement on normothermic regional perfusion in donation after circulatory death: Report from the European Society for Organ Transplantation’s Transplant Learning Journey

et al. 2021

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Summary Normothermic regional perfusion (NRP) in donation after circulatory death (DCD) is a safe alternative to in situ cooling and rapid procurement. An increasing number of countries and centres are performing NRP, a technically and logistically challenging procedure. This consensus document provides evidence‐based recommendations on the use of NRP in uncontrolled and controlled DCDs. It also offers minimal ethical, logistical and technical requirements that form the foundation of a safe and effective NRP programme. The present article is based on evidence and opinions formulated by a panel of European experts of Workstream 04 of the Transplantation Learning Journey project, which is part of the European Society for Organ Transplantation.

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Section: Minimal Logistic Requirements For Nrpmentioning

confidence: 99%

Consensus statement on normothermic regional perfusion in donation after circulatory death: Report from the European Society for Organ Transplantation’s Transplant Learning Journey

et al. 2021

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“…In our study the majority of NRP procedures were performed by local teams, even in low volume centers. Feasibility of setting up a mobile team to allow hospitals without NRP experience to participate in cDCD programs have been reported [23]. However, this strategy presents additional logistical challenges, which may hamper broader acceptability of cDCD procurement.…”

Section: Discussionmentioning

confidence: 99%

Graft utilization after normothermic regional perfusion in controlled donation after circulatory death—a single‐center perspective from France

et al. 2021

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Normothermic regional perfusion (NRP) in controlled donation after circulatory death (cDCD) is a promising procurement strategy. However, a detailed analysis of graft utilization rates is lacking. This retrospective study included all cDCD donors proposed to a single center for NRP procurement of at least one abdominal organ from 2015 to 2020. Utilization rates were defined as the proportion of transplanted grafts from proposed donors in which withdrawal of life sustaining therapies (WLST) was initiated. In total, 125 cDCD donors underwent WLST with transplantation of at least one graft from 109 (87%) donors. In a total of 14 (11%) procedures NRP failure led to graft discard. Utilization rates for kidney and liver grafts were 83% and 59%, respectively. In 44% of the discarded livers, the reason was poor graft quality based on functional donor warm ischemia >45 min, macroscopic aspect, high-transaminases release, or pathological biopsy. In this study, abdominal NRP in cDCD lead to transplantation of at least one graft in the majority of cases. While the utilization rate for kidneys was high, nearly half of the liver grafts were discarded. Cannulation training, novel graft viability markers, and ex-vivo liver graft perfusion may allow to increase graft utilization.

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Ethical Considerations

Janjic¹,

Šušak

2023

ECMO Retrieval Program Foundation

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Mobile Extracorporeal Membrane Oxygenation Teams for Organ Donation After Circulatory Death

Cited by 7 publications

References 25 publications

Consensus statement on normothermic regional perfusion in donation after circulatory death: Report from the European Society for Organ Transplantation’s Transplant Learning Journey

Consensus statement on normothermic regional perfusion in donation after circulatory death: Report from the European Society for Organ Transplantation’s Transplant Learning Journey

Graft utilization after normothermic regional perfusion in controlled donation after circulatory death—a single‐center perspective from France

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