Donation after circulatory death: Possible strategies for in-situ organ preservation

Research output: Contribution to journalReview articlepeer-review

Abstract

Donation after circulatory death (DcD) is an accepted strategy to expand the potential donor pool. the complexity of organ procurement from DcD donors requires the development of new strategies for organ preservation. standard DcD organ recovery involves a super rapid technique, with cold thoracic and abdominal perfusion. However, the conventional methods of preservation based on static and hypothermic storage may not be the most appropriate for DcD grafts, especially in the presence of long warm ischemia times. new strategies designed to improve the preservation of in-situ DcD grafts include the use of normothermic regional perfusion (nrP) for abdominal organs and concomitant cold lung flushing. The use of in-situ NRP is a significant advance in abdominal organ retrieval and it has the potential to increase organ recovery rates due to its applicability in both controlled and uncontrolled DcD donors. We describe an innovative preservation strategy based on the combination of donor nrP for abdominal organ preservation and a normothermic open-lung approach with protective mechanical ventilation for lung preservation.

Original languageEnglish
Pages (from-to)984-991
Number of pages8
JournalMinerva Anestesiologica
Volume86
Issue number9
DOIs
Publication statusPublished - Sep 2020

Keywords

  • Extracorporeal membrane oxygenation
  • Liver transplantation
  • Reperfusion injury
  • Tissue and organ procurement
  • Ventilation
  • Warm ischemia

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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