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https://www.readbyqxmd.com/read/28597777/improved-metabolism-and-redox-state-with-a-novel-preservation-solution-implications-for-donor-lungs-after-cardiac-death-dcd
#1
David A Schipper, Anthony V Louis, Destiny S Dicken, Kitsie Johnson, Ryszard T Smolenski, Stephen M Black, Ray Runyan, John Konhilas, Joe G N Garcia, Zain Khalpey
Lungs donated after cardiac death (DCD) are an underutilized resource for a dwindling donor lung transplant pool. Our study investigates the potential of a novel preservation solution, Somah, to better preserve statically stored DCD lungs, for an extended time period, when compared to low-potassium dextran solution (LPD). We hypothesize that Somah is a metabolically superior organ preservation solution for hypothermic statically stored porcine DCD lungs, possibly improving lung transplant outcomes. Porcine DCD lungs (n = 3 per group) were flushed with and submerged in cold preservation solution...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28574105/development-of-a-prolonged-warm-ex-vivo-perfusion-model-for-kidneys-donated-after-cardiac-death
#2
Daniel Urcuyo, Matthew F Blum, Qiang Liu, Ahmed Nassar, Laura D Buccini, Teresa Diago Uso, Emilio D Poggio, William M Baldwin Iii, David A Goldfarb, Cristiano Quintini
PURPOSE: Ex vivo perfusion of marginal kidney grafts offers the chance to expand the donor pool, but there is no current clinical standard for the prolonged warm perfusion of renal grafts. This exploratory pilot study seeks to identify a stable ex vivo kidney perfusion model that can support low intravascular resistance and preserve histologic architecture in a porcine donation after cardiac death (DCD) model. METHODS: 15 kidneys were preserved in 1 of 3 settings: normothermic whole blood (NT-WB), normothermic Steen Solution™ (XVIVO Perfusion) with whole blood (NT-Steen/WB), or subnormothermic Steen Solution™ at 21°C (SNT-Steen)...
May 24, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28556380/waitlist-outcomes-for-patients-relisted-following-failed-donation-after-cardiac-death-liver-transplant-implications-for-awarding-meld-exception-scores
#3
Kristopher P Croome, David D Lee, Justin H Nguyen, Andrew P Keaveny, C Burcin Taner
Understanding of outcomes for patients re-listed for ischemic cholangiopathy (IC) following a donation after cardiac death (DCD) liver transplant (LT) will help standardization of MELD exception scheme for re-transplantation. Early relisting (E-RL) for DCD graft failure due to PNF or HAT was defined as re-listing ≤ 14 days after DCD-LT, late relisting (L-RL) due to biliary complications was defined as re-listing 14 days- 3 years after DCD-LT. Of 3908 DCD-LT performed nationally between 2002-2016, 540 (13...
May 29, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28553041/a-single-center-experience-of-kidney-transplantation-from-donation-after-circulatory-death-challenges-and-scope-in-india
#4
S Singh, S Kumar, S Dasgupta, D B Kenwar, M Rathi, A Sharma, H S Kohli, V Jha, K L Gupta, M Minz
Donation after circulatory death (DCD) has never been attempted in India because of legal constraints and lack of guidelines for the withdrawal of life support in end-of-life situations. The present report describes the initial experience of transplantation of organs from DCD donors in a tertiary care center in India. Between 2011 and 2015, five donors had kidneys retrieved after cardiac arrest. These patients were declared dead after waiting for 5 min with no electrocardiographic signal on monitor following cardiopulmonary resuscitation (CPR), which was restarted in three patients till organ retrieval...
May 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28538652/association-between-delayed-graft-function-and-graft-loss-in-donation-after-cardiac-death-kidney-transplants-a-paired-kidney-registry-analysis
#5
Wai H Lim, Stephen P McDonald, Graeme R Russ, Jeremy R Chapman, Maggie Km Ma, Henry Pleass, Bryon Jaques, Germaine Wong
BACKGROUND: Delayed graft function (DGF) is an established complication after donation after cardiac death (DCD) kidney transplants, but the impact of DGF on graft outcomes is uncertain. To minimize donor variability and bias, a paired donor kidney analysis was undertaken where 1 kidney developed DGF and the other did not develop DGF using data from the Australia and New Zealand Dialysis and Transplant Registry. METHODS: Using paired DCD kidney data from the Australia and New Zealand Dialysis and Transplant Registry, we examined the association between DGF, graft and patient outcomes between 1994 and 2012 using adjusted Cox regression models...
June 2017: Transplantation
https://www.readbyqxmd.com/read/28521863/high-pre-ischemic-fatty-acid-levels-decrease-cardiac-recovery-in-an-isolated-rat-heart-model-of-donation-after-circulatory-death
#6
Petra Niederberger, Emilie Farine, Maria Arnold, Rahel K Wyss, Maria N Sanz, Natalia Méndez-Carmona, Brigitta Gahl, Georg M Fiedler, Thierry P Carrel, Hendrik T Tevaearai Stahel, Sarah L Longnus
RATIONALE: Donation after circulatory death (DCD) could improve cardiac graft availability. However, strategies to optimize cardiac graft recovery remain to be established in DCD; these hearts would be expected to be exposed to high levels of circulatory fat immediately prior to the inevitable period of ischemia prior to procurement. OBJECTIVE: We investigated whether acute exposure to high fat prior to warm, global ischemia affects subsequent hemodynamic and metabolic recovery in an isolated rat heart model of DCD...
June 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28512290/evolution-of-drug-resistant-acinetobacter-baumannii-after-dcd-renal-transplantation
#7
Hong Jiang, Luxi Cao, Lihui Qu, Tingting Qu, Guangjun Liu, Rending Wang, Bingjue Li, Yuchen Wang, Chaoqun Ying, Miao Chen, Yingying Lu, Shi Feng, Yonghong Xiao, Junwen Wang, Jianyong Wu, Jianghua Chen
Infection after renal transplantation remains a major cause of morbidity and death, especially infection from the extensively drug-resistant bacteria, A. baumannii. A total of fourteen A. baumannii isolates were isolated from the donors' preserved fluid from DCD (donation after cardiac death) renal transplantation and four isolates in the recipients' draining liquid at the Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, from March 2013 to November 2014. An outbreak of A...
May 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28505025/a-rodent-model-of-cardiac-donation-after-circulatory-death-and-novel-biomarkers-of-cardiac-viability-during-ex-vivo-heart-perfusion
#8
Mark J Kearns, Sally Miller, Anson Cheung, Jamil Bashir, Stephanie Wong, Michael A Seidman, John H Boyd
BACKGROUND: Organ donation after circulatory death (DCD) is increasingly being used as a means of addressing the organ supply/demand mismatch in solid organ transplantation. There is reluctance to use DCD hearts, due to an inability to precisely identify hearts that have suffered irreversible injury. We investigated novel biomarkers and clinically relevant endpoints across a spectrum of warm ischemic times (WITs), prior to and during ex vivo heart perfusion (EVHP), to identify features associated with a non-viable cardiac phenotype...
May 13, 2017: Transplantation
https://www.readbyqxmd.com/read/28457385/blood-lactate-concentrations-before-and-after-withdrawal-of-life-sustaining-treatments-in-controlled-donation-after-circulatory-death-a-case-report-from-italy
#9
F Baroncelli, M C Alberione, V Cacciotti, D Artusio, M Vergano, S Livigni
A 20-minute hands-off period with isoelectric electrocardiography (ECG) monitoring is currently required for the declaration of cardiac death in Italy, thus prolonging the warm ischemia time (WIT) during donation after circulatory death (DCD). Normothermic regional perfusion (NRP) can be a valid tool to optimize organ perfusion as a bridge to donation. A 62-year-old woman with catastrophic brain injury due to massive intracranial hemorrage, not fulfilling brain death criteria, underwent controlled DCD after withdrawal of life-sustaining therapies (WLST)...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28403128/an-oxygenated-and-transportable-machine-perfusion-system-fully-rescues-liver-grafts-exposed-to-lethal-ischemic-damage-in-a-pig-model-of-dcd-liver-transplantation
#10
Philippe Compagnon, Eric Levesque, Hassen Hentati, Mara Disabato, Julien Calderaro, Cyrille Feray, Anne Corlu, José Laurent Cohen, Ismail Ben Mosbah, Daniel Azoulay
BACKGROUND: Control of warm ischemia (WI) lesions that occur with donation after circulatory death (DCD) would significantly increase the donor pool for liver transplantation. We aimed to determine whether a novel, oxygenated and hypothermic machine perfusion device (HMP Airdrive system) improves the quality of livers derived from DCDs using a large animal model. METHODS: Cardiac arrest was induced in female large white pigs by IV injection of potassium chloride...
April 11, 2017: Transplantation
https://www.readbyqxmd.com/read/28379853/donation-after-circulatory-death-heart-transplantation
#11
Kumud K Dhital, Hong C Chew, Peter S Macdonald
PURPOSE OF REVIEW: Despite continued expansion in the use of extended-criteria donor hearts following donation after brain death, there remains an unacceptable discrepancy between the supply of suitable donor hearts and the demand from increasing recipient numbers on transplant wait lists. Until recently, the additional approach of utilizing organs following donation after circulatory death (DCD) had not been possible for clinical heart transplantation in the modern era. This review describes relevant advances in translational research and provides an update on the favourable adoption of this donation pathway for clinical heart transplantation...
June 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28376778/outcomes-for-primary-kidney-transplantation-from-donation-after-citizens-death-in-china-a-single-center-experience-of-367-cases
#12
Wujun Xue, Puxun Tian, Heli Xiang, Xiaoming Ding, Xiaoming Pan, Hang Yan, Jun Hou, Xinshun Feng, Linjuan Liu, Chenguang Ding, Xiaohui Tian, Yang Li, Jin Zheng
BACKGROUND: The cases of donation after brain death followed by circulatory death (DBCD) and donation after cardiac death (DCD) have been increased year by year in China. Further research is needed to understand in the outcomes and risk factors of delayed graft function (DGF) in order to minimize the risk of DGF and ameliorate its potential impact on long-term outcomes. This study was to explore the differences in outcomes between DBCD and DCD transplant and the main risk factors for DGF in DBCD...
April 4, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28322103/segmental-portal-superior-mesenteric-vein-resection-and-reconstruction-with-the-iliac-vein-after-pancreatoduodenectomy
#13
Xin Zhao, Li-Xin Li, Hua Fan, Jian-Tao Kou, Xian-Liang Li, Ren Lang, Qiang He
Objective The results of segmental venous resection (VR) combined with pancreatoduodenectomy (PD) are controversial but may be promising. Few studies have described reconstruction of the portal/superior mesenteric vein (PV/SMV) with the iliac vein harvested from donation after cardiac death (DCD). Methods From January 2014 to April 2016, PD combined with segmental excision of the PV/SMV (VR group) was performed in 21 patients with adenocarcinoma of the head of the pancreas (ADHP). The authors established a new technique of venous reconstruction using the iliac vein from DCD and analysed patients' long-term survival...
December 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/28255156/ex-vivo-removal-of-stones-in-donor-kidneys-by-flexible-ureteroscopy-prior-to-renal-transplantation-a-case-report
#14
Na Wang, Honglan Zhou, Bo Shi, Jinguo Wang
BACKGROUND Because of the shortage of grafts, many attempts have been made to treat calculi in donor kidneys and have achieved successful management. This case report is the first to present removal of stones from bilateral kidneys from a single donor through flexible ureteroscopy before transplantation. CASE REPORT The present case report shows the clinical management of bilateral donor kidneys with calculi, which were taken from a 33-year-old man through donation after cardiac death (DCD). Computed tomography showed 2 stones in the right donor kidney and 1 in the left donor kidney...
March 3, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28207629/short-and-long-term-outcome-after-lung-transplantation-from-circulatory-dead-donors-a-single-center-experience
#15
David Ruttens, An Martens, Sofie Ordies, Stijn E Verleden, Arne P Neyrinck, Robin Vos, Marc Boada Collado, Bart M Vanaudenaerde, Geert M Verleden, Dirk Van Raemdonck
BACKGROUND: Donation after cardiac death (DCD) to overcome the donor organ shortage is well accepted in the clinical setting, although long-term outcome after DCD lung transplantation (LTx) remains largely unknown. METHODS: In this retrospective study, DCD LTx recipients (n=59) were compared with a cohort of donation after brain-death (DBD) LTx recipients (n=331) transplanted between February 2007 and September 2013; follow-up was until January 1st 2016. Short-term (duration of mechanical ventilation, ICU stay, hospital stay and highest PGD score within 72 hours) and long-term (CLAD-free and overall survival) follow-up were compared over a median follow-up of 50...
February 15, 2017: Transplantation
https://www.readbyqxmd.com/read/28176336/effect-of-hypothermic-machine-perfusion-on-the-preservation-of-kidneys-donated-after-cardiac-death-a-single-center-randomized-controlled-trial
#16
Wei Wang, Dawei Xie, Xiaopeng Hu, Hang Yin, Hang Liu, Xiaodong Zhang
To assess the application of a hypothermic machine perfusion device (LifePort) in kidney transplantation from donation after cardiac death (DCD) donors, 24 pairs of DCD kidneys were randomly divided into two groups: one of the paired kidneys from the same donor was perfused with the LifePort machine (hypothermic machine perfusion [HMP]), and the contralateral kidney was prepared using common static cold preservation (CCP). The two groups were compared with respect to the incidence of delayed graft function (DGF), level of graft function, and pathological changes in time-zero biopsy specimens...
February 8, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28134286/risk-factors-of-acute-kidney-injury-after-orthotopic-liver-transplantation-in-china
#17
Yin Zongyi, Li Baifeng, Zou Funian, Li Hao, Wang Xin
In this study, we determined the risk factors for acute kidney injury (AKI) following orthotopic liver transplantation (OLT) in China. We collected 5074 donation after cardiac death (DCD) OLT recipients who underwent surgery between January 1, 2010, and December 31, 2015, in 86 academic hospitals or transplant centers in China. Univariate and multivariate analyses were used to investigate the criticality of donor, graft, or recipient variables in the development of post-OLT AKI. In all, 4482 patients were included (median age, 49...
January 30, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28088954/-experiences-of-rescuing-infective-arterial-hemorrhage-and-pseudoaneurysm-in-dcd-kidney-transplantation
#18
D D Zhao, L Q Hong, Z Y Huang, N Na, X F Hua, B Miao, H Li, Q Q Sun
Objective: To summarize experiences of rescuing arterial hemorrhage and pseudoaneurysm caused by infection in donation after cardiac death (DCD) kidney transplantation. Methods: A total of 198 consecutive DCD kidney transplantations between 1 June 2013 and 30 July 2016 in the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. The means of rescuing infective arterial hemorrhage and pseudoaneurysm after operation and their therapeutic effects were summarized. Results: A total of 5 infective arterial hemorrhage, 2 infective pseudoaneurysm with hemorrhage, and 1 infective pseudoaneurysm developed in 198 DCD kidney transplantation recipients with total morbidity of 4...
January 10, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28027600/comparison-of-longterm-outcomes-and-quality-of-life-in-recipients-of-donation-after-cardiac-death-liver-grafts-with-a-propensity-matched-cohort
#19
Kristopher P Croome, David D Lee, Dana K Perry, Justin M Burns, Justin H Nguyen, Andrew P Keaveny, C Burcin Taner
The use of liver grafts from donation after cardiac death (DCD) has been limited due to the increased rate of graft failure, mostly related to ischemic cholangiopathy (IC). It is our hypothesis that longterm outcomes and quality of life (QOL) similar to patients undergoing liver transplantation (LT) with donation after brain death (DBD) can be achieved. Clinical outcomes of all patients undergoing DCD LT (n = 300) between 1998 and 2015 were compared with a propensity score-matched cohort of patients undergoing DBD LT (n = 300)...
March 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28018761/improving-donor-conversion-rates-at-a-level-one-trauma-center-impact-of-best-practice-guidelines
#20
Rodrigo F Alban, Bobby L Gibbons, Vanessa L Bershad
BACKGROUND: Organ availability is a consistently limiting factor in transplant surgery. A primary driver of this limitation is donor conversion rate, which is defined as the percentage of eligible donors for whom procurement is actually performed. An alternative way to increase organ availability is through improved utilization of organs from donors after cardiac death (DCD). Recently, a concerted, multidisciplinary effort has been made within our system to improve conversion rates and DCD utilization, thus increasing organ availability...
November 22, 2016: Curēus
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