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https://www.readbyqxmd.com/read/27916176/functional-assessment-and-transplantation-of-the-donor-heart-after-circulatory-death
#1
Simon J Messer, Richard G Axell, Simon Colah, Paul A White, Marian Ryan, Aravinda A Page, Barbora Parizkova, Kamen Valchanov, Christopher W White, Darren H Freed, Euan Ashley, John Dunning, Martin Goddard, Jayan Parameshwar, Christopher J Watson, Thomas Krieg, Ayyaz Ali, Steven Tsui, Stephen R Large
BACKGROUND: After a severe shortage of brain-dead donors, the demand for heart transplantation has never been greater. In an attempt to increase organ supply, abdominal and lung transplant programs have turned to the donation after circulatory-determined death (DCD) donor. However, because heart function cannot be assessed after circulatory death, DCD heart transplantation was deemed high risk and never adopted routinely. We report a novel method of functional assessment of the DCD heart resulting in a successful clinical program...
December 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27861290/pathophysiological-trends-during-withdrawal-of-life-support-implications-for-organ-donation-after-circulatory-death
#2
Arjun Iyer, Hong Chee Chew, Ling Gao, Jeanette Villanueva, Mark Hicks, Aoife Doyle, Gayathri Kumarasinghe, Andrew Jabbour, Paul Cassius Jansz, Michael P Feneley, Richard P Harvey, Robert M Graham, Kumud K Dhital, Peter S Macdonald
BACKGROUND: Donation after circulatory death (DCD) provides an alternative pathway to deceased organ transplantation. Although clinical DCD lung, liver, and kidney transplantation are well established, transplantation of hearts retrieved from DCD donors has reached clinical translation only recently. Progress has been limited by concern regarding the viability of DCD hearts. The aim of this study was to document the pathophysiological changes that occur in the heart and circulation during withdrawal of life (WLS) support...
December 2016: Transplantation
https://www.readbyqxmd.com/read/27651939/current-status-and-problems-of-lung-transplantation-in-japan
#3
REVIEW
Hiroshi Date
Lung transplantation has been performed worldwide and recognized as an effective treatment for patients with various end-stage lung diseases. Shortage of lung donors is one of the main obstacles in most of the countries, especially in Japan. Every effort has been made to promote organ donation during the past 20 years. In 2010, Japanese transplant low was revised so that the family of the brain dead donors can make a decision for organ donation. Since then, the number of cadaveric lung donor has increased by 5-fold...
August 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27514498/steroids-can-reduce-warm-ischemic-reperfusion-injury-in-a-porcine-dcd-model-with-evlp-evaluation
#4
An Martens, Marc Boada, Bart M Vanaudenaerde, Stijn E Verleden, Robin Vos, Geert M Verleden, Eric K Verbeken, Dirk Van Raemdonck, Dominique Schols, Sandra Claes, Arne P Neyrinck
Donation after circulatory death (DCD) is being used to increase the number of transplantable organs. The role and timing of steroids in DCD donation and ex-vivo lung perfusion (EVLP) has not been thoroughly investigated. In this study, we investigated the effect of steroids on warm-ischemic injury in a porcine model (n=6/group). Following cardiac arrest, grafts were left untouched in the donor (90 minutes warm ischemia). Graft function was assessed after 6 hours of EVLP. In MP-group, 500 mg methylprednisolone was given prior to cardiac arrest and during EVLP...
August 12, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27109193/attenuation-of-pulmonary-ischemia-reperfusion-injury-by-adenosine-a2b-receptor-antagonism
#5
Mary E Huerter, Ashish K Sharma, Yunge Zhao, Eric J Charles, Irving L Kron, Victor E Laubach
BACKGROUND: Ischemia-reperfusion injury (IRI) is a major source of morbidity and mortality after lung transplantation. We previously demonstrated a proinflammatory role of adenosine A2B receptor (A2BR) in lung IR injury. The current study tests the hypothesis that A2BR antagonism is protective of ischemic lungs after in vivo reperfusion or ex vivo lung perfusion (EVLP). METHODS: Mice underwent lung IR with or without administration of ATL802, a selective A2BR antagonist...
August 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/26991858/new-classification-of-donation-after-circulatory-death-donors-definitions-and-terminology
#6
REVIEW
Marie Thuong, Angel Ruiz, Patrick Evrard, Michael Kuiper, Catherine Boffa, Mohammed Z Akhtar, James Neuberger, Rutger Ploeg
In the face of a crisis in organ donation, the transplant community are increasingly utilizing donation after circulatory death (DCD) donors. Over the last 10 years, with the increasing usage of DCD donors, we have seen the introduction in a number of new terms and definitions. We report the results of the 6th International Conference in Organ Donation held in Paris in 2013 and report a consensus agreement of an established expert European Working Group on the definitions and terminology regarding DCD donation, including refinement of the Maastricht definitions...
July 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/26718316/dcd-lung-donation-donor-criteria-procedural-criteria-pulmonary-graft-function-validation-and-preservation
#7
REVIEW
Michiel E Erasmus, Dirk van Raemdonck, Mohammed Zeeshan Akhtar, Arne Neyrinck, David Gomez de Antonio, Andreas Varela, John Dark
In an era where there is a shortage of lungs for transplantation is increased utilization of lungs from donation after circulatory death (DCD) donors. We review the reports of 11 controlled and 1 uncontrolled DCD programs focusing on donor criteria, procedural criteria, graft assessment, and preservation techniques including the use of ex vivo lung perfusion. We have formulated conclusions and recommendations for each of these areas, which were presented at the 6th International Conference on Organ Donation...
July 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/26651884/organotypic-lung-culture-a-new-model-for-studying-ischemia-and-ex-vivo-perfusion-in-lung-transplantation
#8
Jean-Marc Baste, Arnaud Gay, Hassiba Smail, Romain Noël, Michael Bubenheim, Hugues Begueret, Jean-Paul Morin, Pierre-Yves Litzler
AIM: Donors after cardiac death (DCD) in lung transplantation is considered as a solution for organ shortage. However, it is characterized by warm ischemic period, which could be involved in severe Ischemia-Reperfusion lesion (IR) with early graft dysfunction. We describe a new hybrid model combining in vivo ischemia followed by in vitro reoxygenation using organ-specific culture. MATERIAL AND METHODS: A hybrid model using in vivo ischemic period followed by in vitro lung slice reoxygenation was set up in rat to mimic DCD in lung transplantation with in vitro perfusion...
2015: Experimental Lung Research
https://www.readbyqxmd.com/read/26516669/changing-patterns-of-organ-donation-brain-dead-donors-are-not-being-lost-by-donation-after-circulatory-death
#9
Helen M Nelson, Alexandra K Glazier, Francis L Delmonico
The clinical characteristics of all New England Organ Bank (NEOB) donors after circulatory death (DCD) donors were analyzed between July 1, 2009, and June 30, 2014. During that 5-year period, there were 494 authorized medically suitable potential DCDs that the NEOB evaluated, constituting more than 30% of deceased donors coordinated annually by the NEOB. From the cohort of 494 authorized potential DCDs, 331 (67%) became actual DCD, 82 (17%) were attempted as a DCD but did not progress to donation, and 81 (16%) transitioned to an actual donor after brain death (DBD)...
February 2016: Transplantation
https://www.readbyqxmd.com/read/26500001/lungs-exposed-to-1-hour-warm-ischemia-without-heparin-before-harvesting-might-be-suitable-candidates-for-transplantation
#10
Annika Liersch-Nordqvist, Richard Ingemansson, Leif Pierre, Joanna Hlebowicz, Sandra Lindstedt
BACKGROUND: The limiting factor for lung transplantation is the lack of donor organs. The usage of lungs from donation after cardiac death (DCD) would dramatically increase donor availability. In the present paper we wanted to investigate lungs exposed to 1 h of warm ischemia without heparin followed by flush-perfusion and cold storage compared to lungs harvested from heart beating donors (HBD) using standard harvesting technique. METHODS: Twelve Swedish domestic pigs were randomized into two groups...
2015: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/26454741/international-society-for-heart-and-lung-transplantation-donation-after-circulatory-death-registry-report
#11
Marcelo Cypel, Bronwyn Levvey, Dirk Van Raemdonck, Michiel Erasmus, John Dark, Robert Love, David Mason, Allan R Glanville, Daniel Chambers, Leah B Edwards, Josef Stehlik, Marshall Hertz, Brian A Whitson, Roger D Yusen, Varun Puri, Peter Hopkins, Greg Snell, Shaf Keshavjee
BACKGROUND: The objective of this study was to review the international experience in lung transplantation using lung donation after circulatory death (DCD). METHODS: In this retrospective study, data from the International Society for Heart and Lung Transplantation (ISHLT) DCD Registry were analyzed. The study cohort included DCD lung transplants performed between January 2003 and June 2013, and reported to the ISHLT DCD Registry as of April 2014. The participating institutions included 10 centers in North America, Europe and Australia...
October 2015: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/26402739/does-traumatic-donor-cause-of-death-influence-outcome-after-lung-transplantation-a-single-centre-analysis
#12
Kevin Pilarczyk, Jens Heckmann, Henning Carstens, Jura Lubarski, Heinz Jakob, Nikolaus Pizanis, Markus Kamler
Background Owing to the shortage of donor organs in lung transplantation (LuTX), liberalization of donor selection criteria has been proposed. However, some studies suggested that donor traumatic brain damage might influence posttransplantation allograft function. This article aimed to investigate the association of donor cause of death (DCD) and outcome after LuTX. Methods A retrospective analysis of 186 consecutive double LuTXs at our institution from January 2000 to December 2008 was performed. DCD was categorized into traumatic brain injury (TBI) and nontraumatic brain injury (NTBI)...
September 24, 2015: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/26323621/ex-vivo-lung-perfusion-with-adenosine-a2a-receptor-agonist-allows-prolonged-cold-preservation-of-lungs-donated-after-cardiac-death
#13
Cynthia E Wagner, Nicolas H Pope, Eric J Charles, Mary E Huerter, Ashish K Sharma, Morgan D Salmon, Benjamin T Carter, Mark H Stoler, Christine L Lau, Victor E Laubach, Irving L Kron
OBJECTIVE: Ex vivo lung perfusion has been successful in the assessment of marginal donor lungs, including donation after cardiac death (DCD) donor lungs. Ex vivo lung perfusion also represents a unique platform for targeted drug delivery. We sought to determine whether ischemia-reperfusion injury would be decreased after transplantation of DCD donor lungs subjected to prolonged cold preservation and treated with an adenosine A2A receptor agonist during ex vivo lung perfusion. METHODS: Porcine DCD donor lungs were preserved at 4°C for 12 hours and underwent ex vivo lung perfusion for 4 hours...
February 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/26262504/ex-vivo-perfusion-with-adenosine-a2a-receptor-agonist-enhances-rehabilitation-of-murine-donor-lungs-after-circulatory-death
#14
Matthew L Stone, Ashish K Sharma, Valeria R Mas, Ricardo C Gehrau, Daniel P Mulloy, Yunge Zhao, Christine L Lau, Irving L Kron, Mary E Huerter, Victor E Laubach
BACKGROUND: Ex vivo lung perfusion (EVLP) enables assessment and rehabilitation of marginal donor lungs before transplantation. We previously demonstrated that adenosine A2A receptor (A2AR) agonism attenuates lung ischemia-reperfusion injury. The current study utilizes a novel murine EVLP model to test the hypothesis that A2AR agonist enhances EVLP-mediated rehabilitation of donation after circulatory death (DCD) lungs. METHODS: Mice underwent euthanasia and 60 minutes warm ischemia, and lungs were flushed with Perfadex and underwent cold static preservation (CSP, 60 minutes)...
December 2015: Transplantation
https://www.readbyqxmd.com/read/26262464/expanding-the-lung-donor-pool-advancements-and-emerging-pathways
#15
REVIEW
Jeremie Reeb, Shaf Keshavjee, Marcelo Cypel
PURPOSE OF REVIEW: The number of patients listed for lung transplantation largely exceeds the number of available transplantable organs because of a shortage of organ donors and a low utilization rate of lungs from those donors who are available. In recent years, novel strategies have been developed to increase the donor lung pool: improved donor management, the use of lungs from donations after cardiac death (DCD), the use of lobar lung living-donors (LLLD) and the use of ex-vivo lung perfusion (EVLP) to assess and repair injured donor lungs...
October 2015: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/25986239/ventilation-in-situ-after-cardiac-death-improves-pulmonary-grafts-exposed-to-2-hours-of-warm-ischemia
#16
Leif Pierre, Sandra Lindstedt, Richard Ingemansson
BACKGROUND: The pulmonary donor pool would increase substantially if lungs could be donated after cardiac death (DCD). There have been ethical and legal obstacles since administration of heparin and cooling has to be done immediately after cardiac death. This study examines whether ventilation of DCD lungs without administering heparin or cooling the lungs after cardiac death could improve graft function. METHOD: Twelve donor pigs with a mean bodyweight of 70 kg were randomized into two groups...
2015: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/25777821/impact-of-the-cardiac-arrest-mode-on-cardiac-death-donor-lungs
#17
Tetsu Yamada, Fengshi Chen, Jin Sakamoto, Daisuke Nakajima, Akihiro Ohsumi, Toru Bando, Hiroshi Date
BACKGROUND: Donation after cardiac death (DCD) organs could alleviate the shortage of donor lungs. This study aimed to assess the influence on lung injuries of the way in which cardiac arrest was induced and to investigate the mechanisms leading to any differences. MATERIALS AND METHODS: Male rats were allocated into three groups as follows: sham (no warm ischemia), ventricular fibrillation (VF), and asphyxia group. Cardiac arrest was induced by either VF by way of a fibrillator or asphyxia caused by withdrawal of ventilation, which reflected uncontrolled and controlled DCD situations, respectively...
May 15, 2015: Journal of Surgical Research
https://www.readbyqxmd.com/read/25777057/long-term-results-after-lung-transplantation-using-organs-from-circulatory-death-donors-a-propensity-score-matched-analysis%C3%A2
#18
COMPARATIVE STUDY
Anton Sabashnikov, Nikhil P Patil, Aron-Frederik Popov, Simona Soresi, Bartlomiej Zych, Alexander Weymann, Prashant N Mohite, Diana García Sáez, Mohamed Zeriouh, Thorsten Wahlers, Yeong-Hoon Choi, Jens Wippermann, Thorsten Wittwer, Fabio De Robertis, Toufan Bahrami, Mohamed Amrani, André R Simon
OBJECTIVES: Due to organ shortage in lung transplantation (LTx), donation after circulatory death (DCD) has been implemented in several countries, contributing to an increasing number of organs transplanted. We sought to assess long-term outcomes after LTx with organs procured following circulatory death in comparison with those obtained from donors after brain death (DBD). METHODS: Between January 2007 and November 2013, 302 LTxs were performed in our institution, whereby 60 (19...
January 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/25750008/the-effects-of-hydrogen-gas-inhalation-during-ex-vivo-lung-perfusion-on-donor-lungs-obtained-after-cardiac-death
#19
COMPARATIVE STUDY
Seokjin Haam, Sungsoo Lee, Hyo Chae Paik, Moo Suk Park, Joo Han Song, Beom Jin Lim, Atsunori Nakao
OBJECTIVES: Lung transplantation is a well-established treatment of end-stage lung disease; however, it is limited by a shortage of donor lungs. To overcome this problem, donation after cardiac death (DCD) and ex vivo lung perfusion (EVLP) are being widely investigated. In this study, the effect of hydrogen gas, a known antioxidant, was investigated on a DCD lung model during EVLP. METHODS: Ten pigs were randomized into either a control (n = 5) or a hydrogen group (n = 5)...
October 2015: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/25719900/donation-after-circulatory-death-the-current-state-and-technical-approaches-to-organ-procurement
#20
REVIEW
Mohamed F Algahim, Robert B Love
PURPOSE OF REVIEW: In this review, we discuss the current state of donation after circulatory death (DCD). We define the DCD donor and describe the current protocols in management of the DCD patient. We then discuss current techniques in organ procurement of the lung and abdominal organs. RECENT FINDINGS: Although donation after brain death is preferable to DCD, recent data have demonstrated acceptable early outcomes in both thoracic and abdominal organ transplant...
April 2015: Current Opinion in Organ Transplantation
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