Transplantation of a heart donated after circulatory death via thoraco-abdominal normothermic regional perfusion and res
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(2020) 15:333
CASE REPORT
Open Access
Transplantation of a heart donated after circulatory death via thoraco-abdominal normothermic regional perfusion and results from the first Spanish case Marina Pérez Redondo1* , Sara Alcántara Carmona2 , Susana Villar García3 , Alberto Forteza Gil3 , Héctor Villanueva Fernández2 , Francisco José Hernández-Pérez4 , José Luis Campo-Cañaveral de la Cruz5 , Rocío Velasco Calvo6 , Javier Segovia-Cubero4,7 , Beatriz Alonso Menárguez8 , Francisco del Río Gallegos9 , Elisabeth Coll10 , Beatriz Domínguez-Gil González10 and Juan José Rubio Muñoz1
Abstract Background: Controlled donation after circulatory death (cDCD) has emerged as one of the main strategies for increasing the organ donor pool. Because of the ischemic injury that follows the withdrawal of life-sustaining therapies, hearts from cDCD donors have not been considered for transplantation until recently. The ex-situ perfusion of hearts directly procured from cDCD donors has been used to allow the continuous perfusion of the organ and the assessment of myocardial viability prior to transplantation. Based on our experience with abdominal normothermic regional perfusion in cDCD, we designed a protocol to recover and validate hearts from cDCD donors using thoraco-abdominal normothermic regional perfusion without the utilization of an ex-situ device. Case presentation: We describe the first case of a cDCD heart transplant performed with this approach in Spain. The donor was a 43-year-old asthmatic female diagnosed with severe hypoxic encephalopathy. She was considered a potential cDCD donor and a suitable candidate for multiorgan procurement including the heart via thoracoabdominal normothermic regional perfusion. The heart recipient was a 60-year-old male diagnosed with amyloid cardiomyopathy. Cold ischemia time was 55 min. The surgery was uneventful. Conclusions: This case report, the first of its kind in Spain, supports the feasibility of evaluating and successfully transplanting cDCD hearts without the need for ex-situ perfusion based on the use of thoraco-abdominal normothermic regional perfusion opening the way for multiorgan donation in cDCD. Keywords: Controlled donation after circulatory death, Heart transplantation, Normothermic regional perfusion, Case report
* Correspondence: [email protected] 1 Department of Intensive Care Medicine Department of Donor and Transplant Coordination, Hospital Universitario Puerta de Hierro Majadahonda. Instituto de investigación sanitaria Puerta de Hierro – Segovia de Arana, Madrid, Spain Full list of author information is available at the end of the article
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material
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