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Heart arrest donation

Christopher White, Emma Ambrose, Alison Müller, Sanaz Hatami, Yun Li, Hoa Le, James Thliveris, Rakesh Arora, Trevor Lee, Ian Dixon, Ganghong Tian, Jayan Nagendran, Larry Hryshko, Darren Freed
BACKGROUND: Hearts donated after circulatory death may represent an additional donor source. The influx of sodium and calcium ions across the sarcolemma play a central role in the pathogenesis of ischemia-reperfusion injury; however, this process may be inhibited if the initial reperfusion solution is rendered hypocalcemic and acidic. We sought to determine the calcium concentration and pH of the initial reperfusion solution that yielded optimal functional recovery of hearts donated after circulatory death during ex vivo heart perfusion...
August 12, 2016: Annals of Thoracic Surgery
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
N A Trekova, E R Charchyan, B A Akselrod, M N Seleznev, D A Guskov, I N Solovyeva
Questions of saving of the patient's blood and limitation of the use of donated blood in the aortic surgery remain relevant in contrast with interventions on the valves of the heart and coronary arteries. In this regard, the aim of the study was to develop and introduce ofcomplex of technologies for saving the patient's blood in order to minimize transfusion of donor blood components during operations on the ascending aorta and aortic arch under hypothermic arrest. The study included 37 patients operated on the ascending aorta and aortic arch under cardiopulmonary bypass (CPB) and hypothermic cardiac arrest (CA) in 2013-2014 (Group 1)...
September 2015: Anesteziologiia i Reanimatologiia
W Heide
The death of the donor is a mandatory prerequisite for organ transplantation (dead donor rule) worldwide. It is a medical, legal and ethical consensus to accept the concept of brain death, as first proposed in 1968 by the ad hoc committee of the Harvard Medical School, as a certain criterion of death. In isolated cases where the diagnosis of brain death was claimed to be wrong, it could be demonstrated that the diagnostic procedure for brain death had not been correctly performed. In March 2014 a joint statement by the German neuromedical societies emphasized that 1) the diagnosis of brain death is one of the safest diagnoses in medicine if performed according to accepted medical standards and criteria and 2) the concept of non-heart-beating donors (NHBD, i...
February 2016: Der Nervenarzt
C W White, E Ambrose, A Müller, Y Li, H Le, J Thliveris, R C Arora, T W Lee, I M C Dixon, G Tian, J Nagendran, L V Hryshko, D H Freed
The resuscitation of hearts donated after circulatory death (DCD) is gaining widespread interest; however, the method of initial reperfusion (IR) that optimizes functional recovery has not been elucidated. We sought to determine the impact of IR temperature on the recovery of myocardial function during ex vivo heart perfusion (EVHP). Eighteen pigs were anesthetized, mechanical ventilation was discontinued, and cardiac arrest ensued. A 15-min standoff period was observed and then hearts were reperfused for 3 min at three different temperatures (5°C; N = 6, 25°C; N = 5, and 35°C; N = 7) with a normokalemic adenosine-lidocaine crystalloid cardioplegia...
March 2016: American Journal of Transplantation
C W White, R Lillico, J Sandha, D Hasanally, F Wang, E Ambrose, A Müller, O Rachid, Y Li, B Xiang, H Le, S Messer, A Ali, S R Large, T W Lee, I M C Dixon, T M Lakowski, K Simons, R C Arora, G Tian, J Nagendran, L V Hryshko, D H Freed
Hearts donated following circulatory death (DCD) may represent an additional source of organs for transplantation; however, the impact of donor extubation on the DCD heart has not been well characterized. We sought to describe the physiologic changes that occur following withdrawal of life-sustaining therapy (WLST) in a porcine model of DCD. Physiologic changes were monitored continuously for 20 min following WLST. Ventricular pressure, volume, and function were recorded using a conductance catheter placed into the right (N = 8) and left (N = 8) ventricles, and using magnetic resonance imaging (MRI, N = 3)...
March 2016: American Journal of Transplantation
Olivier Van Caenegem, Christophe Beauloye, Luc Bertrand, Sandrine Horman, Sophie Lepropre, Grégory Sparavier, Jonathan Vercruysse, Noëlla Bethuyne, Alain J Poncelet, Pierre Gianello, Peter Demuylder, Eric Legrand, Gwen Beaurin, Françoise Bontemps, Luc M Jacquet, Jean-Louis Vanoverschelde
OBJECTIVES: Cardiac transplantation using hearts from donors after circulatory death (DCD) is critically limited by the unavoidable warm ischaemia and its related unpredictable graft function. Inasmuch as hypothermic machine perfusion (MP) has been shown to improve heart preservation, we hypothesized that MP could enable the use of DCD hearts for transplantation. METHODS: We recovered 16 pig hearts following anoxia-induced cardiac arrest and cardioplegia. Grafts were randomly assigned to two different groups of 4-h preservation using either static cold storage (CS) or MP (Modified LifePort© System, Organ Recovery Systems©, Itasca, Il)...
May 2016: European Journal of Cardio-thoracic Surgery
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
L Zou, J Liu, H Zhang, S Wu, C Long, B Ji, Z Yu, Y Tang, L Meng, A Wu
OBJECTIVE: Due to the weak ascending aorta, it is extremely challenging to establish an anterograde selective cerebral perfusion (ASCP) model in rabbits, especially when cardioplegic arrest is required. Herein, the aim of this study was to establish a rabbit ASCP model with cardiac arrest being easily performed and being similar to the clinical scenario. MATERIALS AND METHODS: Twenty-two adult New Zealand white rabbits were selected for ASCP model establishment and another 22 rabbits were utilized for blood donation...
May 2016: Perfusion
Kenji Inaba, Konstantinos Chouliaras, Scott Zakaluzny, Stuart Swadron, Thomas Mailhot, Dina Seif, Pedro Teixeira, Emre Sivrikoz, Crystal Ives, Galinos Barmparas, Nikolaos Koronakis, Demetrios Demetriades
OBJECTIVE: The objective of this study was to examine the ability of Focused Assessment Using Sonography for Trauma (FAST) to discriminate between survivors and nonsurvivors undergoing resuscitative thoracotomy (RT). BACKGROUND: RT is a high-risk, low-salvage procedure performed in arresting trauma patients with poorly defined indications. METHODS: Patients undergoing RT from 10/2010 to 05/2014 were prospectively enrolled. A FAST examination including parasternal/subxiphoid cardiac views was performed before or concurrent with RT...
September 2015: Annals of Surgery
Cecilia Lucía Balaban, Joaquín Valentín Rodríguez, Claudio Tiribelli, Edgardo Elvio Guibert
Liver transplantation is currently the preferred treatment option for end-stage liver disease. Donation after cardiac death was a common practice in the early years of organ donation before brain death criteria were established. Those organs were subjected to variable periods of warm ischemia that might intensify cold ischemia/reperfusion injuries. In the present, shortage of brain dead donors has led to the reassessment of organ donation after cardiac death. Since many cytoprotective roles have been describe for H2S during ischemia/reperfusion on a variety of tissues, we hypothesized that graft exposure to this bioactive gas might improve preservation of non-heart beating donated organs...
August 2015: Cryobiology
Peter Macdonald, Deborah Verran, Michael O'Leary, Elena Cavazzoni, Kumud Dhital
No abstract text is available yet for this article.
June 2015: Transplantation
David Pilcher, Laura Gladkis, Byron Arcia, Michael Bailey, David Cook, Yael Cass, Helen Opdam
BACKGROUND: The Australian DonateLife Audit captures information on all deaths which occur in emergency departments, intensive care units and in those recently discharged from intensive care unit. This information provides the opportunity to estimate the number of donors expected, given present consent rates and contemporary donation practices. This may then allow benchmarking of performance between hospitals and jurisdictions. Our aim was to develop a method to estimate the number of donors using data from the DonateLife Audit on the basis of baseline patient characteristics alone...
October 2015: Transplantation
Kumud K Dhital, Arjun Iyer, Mark Connellan, Hong C Chew, Ling Gao, Aoife Doyle, Mark Hicks, Gayathri Kumarasinghe, Claude Soto, Andrew Dinale, Bruce Cartwright, Priya Nair, Emily Granger, Paul Jansz, Andrew Jabbour, Eugene Kotlyar, Anne Keogh, Christopher Hayward, Robert Graham, Phillip Spratt, Peter Macdonald
BACKGROUND: Orthotopic heart transplantation is the gold-standard long-term treatment for medically refractive end-stage heart failure. However, suitable cardiac donors are scarce. Although donation after circulatory death has been used for kidney, liver, and lung transplantation, it is not used for heart transplantation. We report a case series of heart transplantations from donors after circulatory death. METHODS: The recipients were patients at St Vincent's Hospital, Sydney, Australia...
June 27, 2015: Lancet
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
P N Mohite, N P Patil, A Sabashnikov, B Zych, D García Sáez, A F Popov, F De Robertis, T Bahrami, M Amrani, A Reed, M Carby, A R Simon
BACKGROUND: Suicidal hanging may cause compression of the neck blood vessels and the airway leading, to hypoxic brain damage caused by cerebral ischemia and respiratory distress. Hanging engenders global tissue hypoxia, particularly affecting the lungs as the result of pulmonary edema and barotrauma. There is scant evidence about outcomes of transplantation with the use of lungs from "hanging donors." This study evaluates the outcomes of lung transplantations (LTx) that use organs from this group...
March 2015: Transplantation Proceedings
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
Joohyun Kim, Michael A Zimmerman
PURPOSE OF REVIEW: This article reviews current strategies for living-donor organ procurement in liver, kidney, pancreas, and intestinal transplant. RECENT FINDINGS: Here we summarize current open and laparoscopic approaches to living donation of abdominal organs. SUMMARY: Living donation strategies expand the organ pool in the setting of a significant organ shortage.
April 2015: Current Opinion in Organ Transplantation
M D Salmeron-Rodriguez, M D Navarro-Cabello, M L Agüera-Morales, M Lopez-Andreu, A Rodriguez-Benot, J C Robles-Arista, J M Dueñas-Jurado, J P Campos-Hernandez, M J Requena-Tapia, P Aljama-Garcia
BACKGROUND: Kidney transplantation from donors after cardiac death (Type III Maastricht category) is a therapeutic option for patients with terminal renal failure. MATERIALS AND METHODS: We present a cohort of 8 patients who received a kidney transplant from donors after cardiac death (DCD). We analyzed the analytical results for the first 6 months after transplantation. RESULTS: We included 8 cases of kidney transplants with organs from DCD (Type III Maastricht category)...
January 2015: Transplantation Proceedings
Franz F Immer
No abstract text is available yet for this article.
2015: Swiss Medical Weekly
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