A metabolic approach during normothermic regional perfusion in uncontrolled donors after circulatory death—A pilot study

• DOI: 10.1111/ctr.13387
• Publication Date: 2018-08-22T15:57:04Z
• Authors: Adriano Peris; Chiara Lazzeri; Manuela Bonizzoli; Cristiana Guetti; Laura Tadini Buon...; Giorgio Fulceri; Pier Francesco Ti...; Marco Chiostri; Vincenzo Li Marzi; Sergio Serni; Maria Luisa Migli...
• Keywords: Adult; Male; Brain Death; Adolescent; 610; Pilot Projects; normothermic regional perfusion; 03 medical and health sciences; Extracorporeal Membrane Oxygenation; 0302 clinical medicine; metabolic; 617; Humans; Prospective Studies; Aged; Retrospective Studies; transaminase; lactate; uncontrolled donors after circulatory death; Cold Ischemia; creatinine; Organ Preservation; Organ Transplantation; extracorporeal membrane oxygenation; Middle Aged; creatinine; extracorporeal membrane oxygenation; lactate; metabolic; normothermic regional perfusion; transaminases; uncontrolled donors after circulatory death; Tissue Donors; 3. Good health; Perfusion; Creatinine; Tissue and Organ Harvesting; Female; Follow-Up Studies

AbstractThe use of donation after circulatory death (DCD) has increased significantly to face the persistent mismatch between supply and demand of organs for transplantation. While controlled (c) DCDs have warm ischemic time (WIT) that can be estimated, the WIT is often inexact and extended in uncontrolled DCD (uDCD), making assessment of injury difficult. We aimed at investigating the effects of cold ischemia on potential donor organ damage in the course of nRP by assessing the dynamic variations of transaminases and creatinine values in 17 uDCD donors. In our series, lactate values did not show significant changes during the study period (P = 0.147). Creatinine values did not significantly changed while transaminases progressive increased throughout the study period, even if it was significant only for AST (P = 0.035). According to our data, nRP duration affects splanchnic organs, being the liver sensitive to hypoperfusion, and serial biochemical measurements could help in detecting organ functional status.