“Super-rapid” Technique in Donation After Circulatory Death Liver Donors: Advantages and Disadvantages

Sánchez-Hidalgo, Juan Manuel; Rodríguez‐Ortiz, Lidia; Arjona‐Sánchez, Álvaro; Ayllón-Terán, M.D.; Gómez‐Luque, Irene; Ciria-Bru, Rubén; Luque-Molina, Antonio; López‐Cillero, Pedro; Rufián-Peña, Sebastián; Briceño-Delgado, Javier

doi:10.1016/j.transproceed.2018.05.034

Cited by 6 publications

(3 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several white papers and guidelines regarding DCD organ recovery have been published in the past decade, and this literature has established basic, generalized practices which are currently employed throughout the United States 19‐22 . These guidelines have firmly established several ethical principles including the importance of separating the role of the care team from the role of the recovery team, as well as surgical principles such as descriptions of the super‐rapid recovery technique and the importance of minimizing fDWIT and CIT 12‐14,23,24 . However, little guidance has been published regarding the peri‐procedural details that go beyond these important, but general principles.…”

Section: Discussionmentioning

confidence: 99%

A Step toward Standardization: Results of two National Surveys of Best Practices in Donation after Circulatory Death Liver Recovery and Recommendations from The American Society of Transplant Surgeons and Association of Organ Procurement Organizations

Hobeika

Glazner

Foley

et al. 2020

Clinical Transplantation

View full text Add to dashboard Cite

Donation after circulatory death (DCD) liver allografts remain underutilized. Inconsistent processes for DCD procurement may contribute to allograft discard. Optimal surgical and organ procurement organization (OPO) practices for DCD liver recovery should be developed and adopted. DCD practice surveys were distributed to transplant surgeons and OPO leadership. DCD liver recovery best practices were assembled based on survey data, literature review, and subject‐matter expert consensus opinion. Data were obtained from transplant surgeons (n = 188) and OPO leadership (n = 48 OPOs). Surgeons preferred attending physician presence at recovery (72.4%); while only 27.7% of OPOs require this. Pre‐withdrawal communication huddle (Surgeons: 88.7%; OPOs: 93.8%) and administration of pre‐withdrawal heparin (Surgeons: 90.6%; OPOs: 84.8%) are widely accepted. Surgical preference for withdrawal of support is in the operating room (89.3%); OPO practice varies dependent upon hospital and family requirements. Functional donor warm ischemic time (fDWIT) start time is variable, while fDWIT end time is agreed upon as initiation of aortic flush by surgeons (81%) and OPOs (81%). DCD liver recovery practices including mandatory communication huddle, pre‐withdrawal heparin administration, and clearly defined start and end of fDWIT should be implemented nationally. Creating a set of best practices for DCD recovery guidelines is necessary for improving DCD liver utilization.

show abstract

Section: Discussionmentioning

confidence: 99%

A Step toward Standardization: Results of two National Surveys of Best Practices in Donation after Circulatory Death Liver Recovery and Recommendations from The American Society of Transplant Surgeons and Association of Organ Procurement Organizations

Hobeika

Glazner

Foley

et al. 2020

Clinical Transplantation

View full text Add to dashboard Cite

show abstract

“…This technique continues to be the procedure of choice in some countries. Advantages of SSR from DCD donors are the reduced costs, availability, reproducibility, and the familiarity with the procedure [ 42 ]. Nevertheless, SSR of organs from DCD donors require expertise and surgical skills to minimize the risks of organ injury or even graft loss secondary to surgical accidents [ 43 ].…”

Section: Joint Thoracic and Abdominal Organ Procurement Prom Dcd Donorsmentioning

confidence: 99%

Lung Transplantation in Controlled Donation after Circulatory-Determination-of-Death Using Normothermic Abdominal Perfusion

Moreno,

González-García,

Ruíz-López

et al. 2024

Transpl Int

View full text Add to dashboard Cite

The main limitation to increased rates of lung transplantation (LT) continues to be the availability of suitable donors. At present, the largest source of lung allografts is still donation after the neurologic determination of death (brain-death donors, DBD). However, only 20% of these donors provide acceptable lung allografts for transplantation. One of the proposed strategies to increase the lung donor pool is the use of donors after circulatory-determination-of-death (DCD), which has the potential to significantly alleviate the shortage of transplantable lungs. According to the Maastricht classification, there are five types of DCD donors. The first two categories are uncontrolled DCD donors (uDCD); the other three are controlled DCD donors (cDCD). Clinical experience with uncontrolled DCD donors is scarce and remains limited to small case series. Controlled DCD donation, meanwhile, is the most accepted type of DCD donation for lungs. Although the DCD donor pool has significantly increased, it is still underutilized worldwide. To achieve a high retrieval rate, experience with DCD donation, adequate management of the potential DCD donor at the intensive care unit (ICU), and expertise in combined organ procurement are critical. This review presents a concise update of lung donation after circulatory-determination-of-death and includes a step-by-step protocol of lung procurement using abdominal normothermic regional perfusion.

show abstract

“…Conversely, no significant interaction between donor hepatectomy time and donor type (donation after brain death vs DCD) has been observed, indicating that DCD is equally susceptible to the effect of donor hepatectomy time. A particular type of procurement is the super-rapid technique[ 43 ]. Utilized in DCD donors in case of absence of normothermic regional perfusion, it initiates in less than 4 min after skin incision to reduce the WIT.…”

Section: Cit Stepsmentioning

confidence: 99%

Cold ischemia time in liver transplantation: An overview

Cesaretti,

Izzo,

Pellegrino

et al. 2024

World J Hepatol

View full text Add to dashboard Cite

The standard approach to organ preservation in liver transplantation is by static cold storage and the time between the cross-clamping of a graft in a donor and its reperfusion in the recipient is defined as cold ischemia time (CIT). This simple definition reveals a multifactorial time frame that depends on donor hepatectomy time, transit time, and recipient surgery time, and is one of the most important donor-related risk factors which may influence the graft and recipient’s survival. Recently, the growing demand for the use of marginal liver grafts has prompted scientific exploration to analyze ischemia time factors and develop different organ preservation strategies. This review details the CIT definition and analyzes its different factors. It also explores the most recent strategies developed to implement each timestamp of CIT and to protect the graft from ischemic injury.

show abstract

“Super-rapid” Technique in Donation After Circulatory Death Liver Donors: Advantages and Disadvantages

Cited by 6 publications

References 13 publications

A Step toward Standardization: Results of two National Surveys of Best Practices in Donation after Circulatory Death Liver Recovery and Recommendations from The American Society of Transplant Surgeons and Association of Organ Procurement Organizations

A Step toward Standardization: Results of two National Surveys of Best Practices in Donation after Circulatory Death Liver Recovery and Recommendations from The American Society of Transplant Surgeons and Association of Organ Procurement Organizations

Lung Transplantation in Controlled Donation after Circulatory-Determination-of-Death Using Normothermic Abdominal Perfusion

Cold ischemia time in liver transplantation: An overview

Contact Info

Product

Resources

About