Outcomes of lung and liver transplantation after simultaneous recovery using abdominal normothermic regional perfusion in donors after the circulatory determination of death versus donors after brain death

• Published in: American journal of transplantation Vol. 23; no. 7; pp. 996 - 1008
• Main Authors: Campo-Cañaveral de la Cruz, Jose Luis, Miñambres, Eduardo, Coll, Elisabeth, Padilla, María, Antolín, Gloria Sánchez, de la Rosa, Gloria, Rosado, Joel, González García, Francisco Javier, Crowley Carrasco, Silvana, Sales Badía, Gabriel, Fieria Costa, Eva María, García Salcedo, Jose Alberto, Mora, Victor, de la Torre, Carlos, Badenes, Rafael, Atutxa Bizkarguenaga, Lander, Domínguez-Gil, Beatriz
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2023
• Subjects: Brain Death; Death; donation after brain death; donation after circulatory death; Graft Survival; Humans; Liver Transplantation; Lung; lung transplantation; normothermic regional perfusion; Organ Preservation - methods; Perfusion - methods; rapid recovery; Retrospective Studies; Tissue Donors; donation after brain death; ECMO; RR; LiTx; DBD; LuTx; PNF; IQR; cDCD; PGD; ISHLT; NRP; rapid recovery; lung transplantation; donation after circulatory death; normothermic regional perfusion; FWIT; liver transplantation
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1016/j.ajt.2023.04.016

Normothermic regional perfusion (NRP) in controlled donation after the circulatory determination of death (cDCD) is a growing preservation technique for abdominal organs that coexists with the rapid recovery of lungs. We aimed to describe the outcomes of lung transplantation (LuTx) and liver transplantation (LiTx) when both grafts are simultaneously recovered from cDCD donors using NRP and compare them with grafts recovered from donation after brain death (DBD) donors. All LuTx and LiTx meeting these criteria during January 2015 to December 2020 in Spain were included in the study. Simultaneous recovery of lungs and livers was undertaken in 227 (17%) donors after cDCD with NRP and 1879 (21%) DBD donors (P < .001). Primary graft dysfunction grade-3 within the first 72 hours was similar in both LuTx groups (14.7% cDCD vs. 10.5% DBD; P = .139). LuTx survival at 1 and 3 years was 79.9% and 66.4% in cDCD vs. 81.9% and 69.7% in DBD (P = .403). The incidence of primary nonfunction and ischemic cholangiopathy was similar in both LiTx groups. Graft survival at 1 and 3 years was 89.7% and 80.8% in cDCD vs. 88.2% and 82.1% in DBD LiTx (P = .669). In conclusion, the simultaneous rapid recovery of lungs and preservation of abdominal organs with NRP in cDCD donors is feasible and offers similar outcomes in both LuTx and LiTx recipients to transplants using DBD grafts.
[Display omitted]