Thoracoabdominal Normothermic Regional Perfusion Using Mobile Closed Extracorporeal Circuit in Circulatory Death Determination Heart Donors

被引:1
作者
Antonini, Marta Velia [1 ,2 ]
Martin-Suarez, Sofia [3 ]
Botta, Luca [3 ]
Circelli, Alessandro [1 ]
Cordella, Erika [4 ]
Zani, Gianluca [5 ]
Terzitta, Marina [5 ]
Agnoletti, Vanni [1 ]
Pacini, Davide [3 ]
机构
[1] Bufalini Hosp, Anesthesia & Intens Care Dept, Azienda Unita Sanit Locale AUSL Romagna, Cesena, Italy
[2] Univ Bologna, PhD program Cardionephro Thorac Sci, Bologna, Italy
[3] IRCCS Az Osp Univ Bologna, S Orsola Hosp, Cardiac Surg Unit, Bologna, Italy
[4] Azienda Osped Univ Bologna, Ist Ricovero & Cura Carattere Sci, Emilia Romagna Transplant Reference Ctr, Bologna, Italy
[5] St Maria Croci Hosp, Anesthesia & Intens Care Unit, AUSL Romagna, Ravenna, Italy
关键词
normothermic regional perfusion; NRP; EISOR; ECMO; transplantation;
D O I
10.1097/MAT.0000000000002282
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
Thoracoabdominal normothermic regional perfusion (TA-NRP) is increasingly implemented in donation after circulatory determination of death (DCD). Thoracoabdominal normothermic regional perfusion allows thoracic and abdominal organs to be perfused with warm, oxygenated blood after declaration of death, interrupting ischemia. Evidence is accumulating supporting the use of TA-NRP to improve the outcome of grafts from DCD donors. Thoracoabdominal normothermic regional perfusion may restore and maintain a near-physiological environment during procurement. Moreover, during TA-NRP it is feasible to evaluate the heart in situ. Thoracoabdominal normothermic regional perfusion could be performed through different cannulation techniques, central or peripheral, and, with different extracorporeal circuits. The use of conventional cardiopulmonary bypass and extracorporeal life support (ECLS) devices equipped with open circuits has been described. We report the use of a fully mobile, closed ECLS circuit to implement TA-NRP. The procedure was successfully performed in a peripheral center without a cardiac surgery program through a percutaneous cannulation approach. This strategy resulted in combined heart, liver, and kidney recovery despite a significantly prolonged functional warm ischemia time. The feasibility of TA-NRP using modified but still closed fully mobile ECLS circuits could furtherly support the expansion of DCD programs, increasing the availability of heart for transplantation, and the quality of the grafts, improving recipients' outcome.
引用
收藏
页码:e61 / e65
页数:5
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