Publication: Overcoming lung challenges in TA-NRP assisted heart recovery in donation after the circulatory determination of death
Authors
Royo Villanova, Mario ; Moya Sánchez, José ; Ortín Freire, Alejandro ; Gea García, Jose H. de ; Rebollo Acebes, Sergio ; Moreno Flores, Alba ; Blanco Morillo, Juan ; Cánovas López, Sergio ; Domínguez Gil, Beatriz
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Publisher
Frontiers Media
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DOI
https://doi.org/10.3389/ti.2024.13526
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info:eu-repo/semantics/article
Description
© 2024 Royo-Villanova, Moya Sánchez, Ortín Freire, De Gea García,
Rebollo Acebes, Moreno Flores, Blanco Morillo, Cánovas and Domínguez-Gil. This manuscript version is made available under the CC-BY 4.0 license http://creativecommons.org/licenses/by/4.0/
This document is the Published Manuscript, version of a Published Work that appeared in final form in Transplant International. To access the final edited and published work see https://doi.org/10.3389/ti.2024.13526
Abstract
Thoraco-abdominal normothermic regional perfusion (TA-NRP), utilizing Extra Corporeal Membrane Oxygenation (ECMO) devices, has emerged as an effective strategy for heart recovery in donors declared dead by circulatory criteria (DCDD). After death declaration, TA-NRP restores heart activity by reperfusing the arrested heart with oxygenated blood at normothermia. Mechanical ventilation resumption in the donor enables weaning from ECMO and restores systemic circulation and oxygenation using the donor’s heart and lungs. However, if pre-existing conditions prevent the donor’s lungs from oxygenating blood post-cardiac activity restoration, weaning from veno-arterial ECMO may lead to systemic hypoxia, jeopardizing the restored cardiac function. Anticipating this scenario may guide planning a split ECMO circuit to facilitate earlier and more effective recovery of donor heart function post-ECMO weaning. This manuscript describes three cases of DCDD donors with hypoxic respiratory failure undergoing TA-NRP for heart recovery. By establishing a bridge in the arterial portion of the circuit, clamped out after weaning from veno-arterial ECMO, donor heart function was assessed exclusively with veno-venous ECMO support, leading to successful heart transplantation.
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Citation
Transplant International, 2024, Vol. 37 : 13526
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Este ítem está sujeto a una licencia Creative Commons. http://creativecommons.org/licenses/by/4.0/