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http://dx.doi.org/10.5090/kjtcs.2018.51.5.328

Extracorporeal Life Support in Organ Transplant Donors  

Chang, Wonho (Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University Seoul Hospital)
Publication Information
Journal of Chest Surgery / v.51, no.5, 2018 , pp. 328-332 More about this Journal
Abstract
Background: Extracorporeal life support (ECLS) can be applied in brain-dead donors for organ perfusion before donation, thereby expanding the donor pool. The aim of this study was to examine the benefits and early clinical outcomes of ECLS for organ preservation. Methods: Between June 2012 and April 2017, 9 patients received ECLS with therapeutic intent or for organ preservation. The following data were collected: demographics, purpose and duration of ECLS, cause of death, dose of vasoactive drugs, and need for temporary dialysis before organ retrieval. The early clinical outcomes of recipients were studied, as well as survival and graft function at 1 month. Results: ECLS was initiated for extracorporeal cardiopulmonary resuscitation in 5 patients. The other patients needed ECLS due to hemodynamic deterioration during the assessment of brain death. We successfully retrieved 18 kidneys, 7 livers, and 1 heart from 9 donors. All organs were transplanted and none were discarded. Only 1 case of delayed kidney graft function was noted, and all 26 recipients were discharged without any significant complications. Conclusion: The benefits of protecting the vital organs of donors is significant, and ECLS for organ preservation can be widely used in the transplantation field.
Keywords
Transplantation; Extracorporeal membrane oxygenation; Tissue and organ procurement;
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  • Reference
1 Oosterlee A, Rahmel A. Eurotransplant International Foundation annual report 2010. Leiden: Eurotransplant International Foundation; 2011.
2 Bugge JF. Brain death and its implications for management of the potential organ donor. Acta Anaesthesiol Scand 2009;53:1239-50.   DOI
3 Salim A, Velmahos GC, Brown C, Belzberg H, Demetriades D. Aggressive organ donor management significantly increases the number of organs available for transplantation. J Trauma 2005;58:991-4.   DOI
4 Hsieh CE, Lin HC, Tsui YC, et al. Extracorporeal membrane oxygenation support in potential organ donors for brain death determination. Transplant Proc 2011;43:2495-8.   DOI
5 National Health Service. Potential donor adult summary report for the 12 month period: 1 April 2013-31 March 2014 [Internet]. London: National Health Service; 2014 [cited 2017 May 4]. Available from: https://www.odt.nhs.uk/.
6 Younger JG, Schreiner RJ, Swaniker F, Hirschl RB, Chapman RA, Bartlett RH. Extracorporeal resuscitation of cardiac arrest. Acad Emerg Med 1999;6:700-7.   DOI
7 Ryu JA, Cho YH, Sung K, et al. Predictors of neurological outcomes after successful extracorporeal cardiopulmo- nary resuscitation. BMC Anesthesiol 2015;15:26.   DOI
8 Carter T, Bodzin AS, Hirose H, et al. Outcome of organs procured from donors on extracorporeal membrane oxy- genation support: an analysis of kidney and liver allograft data. Clin Transplant 2014;28:816-20.   DOI
9 Mascia L, Mastromauro I, Viberti S, Vincenzi M, Zanello M. Management to optimize organ procurement in brain dead donors. Minerva Anestesiol 2009;75:125-33.
10 Yang HY, Lin CY, Tsai YT, Lee CY, Tsai CS. Experience of heart transplantation from hemodynamically unstable brain-dead donors with extracorporeal support. Clin Transplant 2012;26:792-6.   DOI
11 Mateen FJ, Muralidharan R, Shinohara RT, Parisi JE, Schears GJ, Wijdicks EF. Neurological injury in adults treated with extracorporeal membrane oxygenation. Arch Neurol 2011;68:1543-9.   DOI
12 Dalle Ave AL, Gardiner D, Shaw DM. The ethics of ex- tracorporeal membrane oxygenation in brain-dead poten- tial organ donors. Transpl Int 2016;29:612-8.   DOI
13 Abrams DC, Prager K, Blinderman CD, Burkart KM, Brodie D. Ethical dilemmas encountered with the use of extracorporeal membrane oxygenation in adults. Chest 2014;145:876-82.   DOI