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Challenges and opportunities in organ donation after circulatory death.
J Intern Med
January 2025
Division of Transplantation Surgery, CLINTEC, Karolinska Institutet, Stockholm, Sweden.
In recent years, there has been resurgence in donation after circulatory death (DCD). Despite that, the number of organs transplanted from these donors remains low due to concerns about their function and a lack of an objective assessment at the time of donation. This overview examines the current DCD practices and the classification modifications to accommodate regional perspectives.
View Article and Find Full Text PDFNormothermic regional and ex-situ perfusion reduces Postreperfusion syndrome in donation after circulatory death liver transplantation: a retrospective comparative study.
Am J Transplant
January 2025
The Roy Calne Transplant Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, Cambridge, UK; University of Cambridge Department of Surgery, Cambridge, UK; National Institute of Health Research (NIHR) Cambridge Biomedical Research Centre, and the NIHR Blood and Transplant Research Unit (BTRU) at the University of Cambridge in collaboration with Newcastle University and in partnership with NHS Blood and Transplant (NHSBT), UK.
In controlled donation after circulatory death (DCD) liver transplantation, ischemia-reperfusion injury is linked to post-reperfusion syndrome (PRS), acute kidney injury (AKI), and early allograft dysfunction (EAD). Normothermic regional perfusion (NRP) and normothermic machine perfusion (NMP) are techniques that mitigate ischemic injury and associated complications. In this single centre retrospective study, we compared early transplant outcomes of DCD livers undergoing direct procurement (DP) and static cold storage (DCD-DP-SCS), NRP procurement with SCS (DCD-NRP-SCS), or DP with NMP (DCD-DP-NMP).
View Article and Find Full Text PDFMachine Learning Algorithms in Controlled Donation After Circulatory Death Under Normothermic Regional Perfusion: A Graft Survival Prediction Model.
Transplantation
January 2025
Hepatobiliary Surgery and Liver Transplantation Unit, Hospital Universitario Reina Sofía, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain.
Background: Several scores have been developed to stratify the risk of graft loss in controlled donation after circulatory death (cDCD). However, their performance is unsatisfactory in the Spanish population, where most cDCD livers are recovered using normothermic regional perfusion (NRP). Consequently, we explored the role of different machine learning-based classifiers as predictive models for graft survival.
View Article and Find Full Text PDFImpact of donor obesity on outcomes of donation after circulatory death heart transplantation.
J Thorac Cardiovasc Surg
December 2024
Division of Cardiothoracic Surgery, Department of Surgery, Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, Va.
Background: In the setting of the obesity epidemic and donor organ shortage in the United States, there is a growing need to expand the donor organ eligibility criteria for orthotopic heart transplantation (OHT). Donation after circulatory death (DCD) has emerged as a promising solution, but the outcomes with obese donor hearts in DCD OHT remains unknown.
Methods: Using the United Network for Organ Sharing registry between 2019 and 2024, recipients of DCD OHT were stratified into 3 donor obesity categories by body mass index (BMI): underweight/normal (BMI <25 kg/m), overweight (BMI 25-30 kg/m), and obese (BMI >30 kg/m).
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