Buscar

Estamos realizando la búsqueda. Por favor, espere...

 Detalle_Publicacion

Uncontrolled Donation After Circulatory Death: A Unique Opportunity

Abstract: Uncontrolled donation after circulatory death (uDCD) refers to donation from persons who die following an unexpected and unsuccessfully resuscitated cardiac arrest. Despite the large potential for uDCD, programs of this kind only exist in a reduced number of countries with a limited activity. Barriers to uDCD are of a logistical and ethical-legal nature, as well as arising from the lack of confidence in the results of transplants from uDCD donors. The procedure needs to be designed to reduce and limit the impact of the prolonged warm ischemia inherent to the uDCD process, and to deal with the ethical issues that this practice poses: termination of advanced cardiopulmonary resuscitation, extension of advanced cardiopulmonary resuscitation beyond futility for organ preservation, moment to approach families to discuss donation opportunities, criteria for the determination of death, or the use of normothermic regional perfusion for the in situ preservation of organs. Although the incidence of primary nonfunction and delayed graft function is higher with organs obtained from uDCD donors, overall patient and graft survival is acceptable in kidney, liver, and lung transplantation, with a proper selection and management of both donors and recipients. Normothermic regional perfusion has shown to be critical to achieve optimal outcomes in uDCD kidney and liver transplantation. However, the role of ex situ preservation with machine perfusion is still to be elucidated. uDCD is a unique opportunity to improve patient access to transplantation therapies and to offer more patients the chance to donate organs after death, if this is consistent with their wishes and values.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: Transplantation . 2020 Aug;104(8):1542-1552

Editorial: Lippincott Williams & Wilkins

 Año de publicación: 2020

Nº de páginas: 11

Tipo de publicación: Artículo de Revista

 DOI: 10.1097/TP.0000000000003139

ISSN: 0041-1337,1534-6080

Url de la publicación: https://doi.org/10.1097/tp.0000000000003139

Autoría

COLL, ELISABETH

SÁNCHEZ FRUCTUOSO, ANA

FONDEVILA, CONSTANTINO

CAMPO CAÑAVERAL DE LA CRUZ, JOSÉ LUIS

DOMÍNGUEZ GIL, BEATRIZ