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Abstract: The use of donation after circulatory death (DCD)
has increased significantly during the past decade.
However, warm ischemia results in a greater risk
for transplantation. Indeed, controlled DCD (cDCD)
was associated with inferior outcomes compared
with donation after brain death. The use of abdominal
normothermic regional perfusion (nRP) to restore
blood flow before organ recovery in cDCD
has been proposed as better than rapid recovery to
reverse the effect of ischemia and improve recipients?
outcome. Here, the first Spanish series using
abdominal nRP as an in situ conditioning method
is reported. A specific methodology to avoid restoring
circulation to the brain after death determination
is described. Twenty-seven cDCD donors
underwent abdominal nRP during at least 60 min.
Thirty-seven kidneys, 11 livers, six bilateral lungs,
and one pancreas were transplanted. The 1-year
death-censored kidney survival was 91%, and
delayed graft function rate was 27%. The 1-year
liver survival rate was 90.1% with no cases of
ischemic cholangiopathy. Transplanted lungs and
pancreas exhibited primary function. The use of
nRP may represent an advance to increase the
number and quality of grafts in cDCD. Poor results
in cDCD livers could be reversed with nRP. Concerns
about restoring brain circulation after death
are easily solved.
Fuente: American Journal of Transplantation 2017; 17: 2165-2172
Editorial: Wiley Periodicals Inc.
Año de publicación: 2017
Nº de páginas: 8
Tipo de publicación: Artículo de Revista
EDUARDO MIÑAMBRES GARCIA
BORJA SUBERVIOLA CAÑAS
DOMÍNGUEZ GIL, B.
EMILIO RODRIGO CALABIA
JUAN CARLOS RUIZ SAN MILLAN
JUAN CARLOS RODRIGUEZ SANJUAN
MARIA ANGELES BALLESTEROS SANZ