keyword
https://read.qxmd.com/read/38501716/beyond-the-final-heartbeat-neurological-perspectives-on-normothermic-regional-perfusion-for-organ-donation-after-circulatory-death
#1
REVIEW
Matthew P Kirschen, Ariane Lewis, Michael A Rubin, Panayiotis N Varelas, David M Greer
Normothermic regional perfusion (NRP) has recently been used to augment organ donation after circulatory death (DCD) to improve the quantity and quality of transplantable organs. In DCD-NRP, after withdrawal of life-sustaining therapies and cardiopulmonary arrest, patients are cannulated onto extracorporeal membrane oxygenation to reestablish blood flow to targeted organs including the heart. During this process, aortic arch vessels are ligated to restrict cerebral blood flow. We review ethical challenges including whether the brain is sufficiently reperfused through collateral circulation to allow reemergence of consciousness or pain perception, whether resumption of cardiac activity nullifies the patient's prior death determination, and whether specific authorization for DCD-NRP is required...
March 19, 2024: Annals of Neurology
https://read.qxmd.com/read/38446085/impact-of-hemoglobin-level-in-ex-vivo-heart-perfusion-on-donation-after-circulatory-death-hearts-a-juvenile-porcine-experimental-model
#2
JOURNAL ARTICLE
Yasuyuki Kobayashi, Jing Li, Marlee Parker, Jian Wang, Anita Nagy, Chun-Po Steve Fan, Kyle Runeckles, Michiru Okumura, Sachiko Kadowaki, Osami Honjo
BACKGROUND: Ex vivo heart perfusion (EVHP) of donation after circulatory death (DCD) hearts has become an effective strategy in adults; however, the small circulating volume in pediatrics poses the challenge of a low-hemoglobin (Hb) perfusate. We aimed to determine the impact of perfusate Hb levels during EVHP on DCD hearts using a juvenile porcine model. METHODS: Sixteen DCD piglet hearts (11-14 kg) were reperfused for 4 h in unloaded mode followed by working mode...
March 6, 2024: Transplantation
https://read.qxmd.com/read/38432523/knowledge-gaps-in-heart-and-lung-donation-after-the-circulatory-determination-of-death-report-of-a-workshop-of-the-national-heart-lung-and-blood-institute
#3
JOURNAL ARTICLE
James L Bernat, Kiran K Khush, Sam D Shemie, Matthew G Hartwig, Peter P Reese, Anne Dalle Ave, J D Brendan Parent, Alexandra K Glazier, Alexander M Capron, Matt Craig, Teneille Gofton, Elisa J Gordon, Andrew Healey, Mary E Homan, Keren Ladin, Simon Messer, Nick Murphy, Thomas A Nakagawa, William F Parker, Rebecca D Pentz, David Rodríguez-Arias, Bryanna Schwartz, Daniel P Sulmasy, Robert D Truog, Anji E Wall, Stephen P Wall, Paul Root Wolpe, Kathleen N Fenton
In a workshop sponsored by the U.S. National Heart, Lung, and Blood Institute, experts identified current knowledge gaps and research opportunities in the scientific, conceptual, and ethical understanding of organ donation after the circulatory determination of death and its technologies. To minimize organ injury from warm ischemia and produce better recipient outcomes, innovative techniques to perfuse and oxygenate organs postmortem in situ, such as thoracoabdominal normothermic regional perfusion, are being implemented in several medical centers in the US and elsewhere...
March 1, 2024: Journal of Heart and Lung Transplantation
https://read.qxmd.com/read/38285740/the-future-of-pediatric-and-adult-heart-transplantation-perspective-from-the-united-states
#4
JOURNAL ARTICLE
Emile Bacha, Maryjane Farr
No abstract text is available yet for this article.
January 30, 2024: Circulation
https://read.qxmd.com/read/38024476/getting-out-of-the-box-the-future-of-the-uk-donation-after-circulatory-determination-of-death-heart-programme
#5
REVIEW
John Onsy Louca, Alex Manara, Simon Messer, Marco Öchsner, David McGiffin, Isabel Austin, Eliza Bell, Savanna Leboff, Stephen Large
Heart failure imposes a significant burden on all health care systems and has a 5-year mortality of 50%. Heart transplantation and ventricular assist device (VAD) implantation are the definitive therapies for end stage heart disease, although transplantation appears to offer superior long-term survival and quality of life over VAD implantation. Transplantation is limited by a shortage in donor hearts, resulting in considerable waiting list mortality. Donation after circulatory determination of death (DCD) offers a significant uplift in the number of donors for heart transplantation...
December 2023: EClinicalMedicine
https://read.qxmd.com/read/37929577/longitudinal-trends-in-donor-and-recipient-risk-profile-and-clinical-outcomes-for-donation-after-circulatory-death-heart-transplantation
#6
JOURNAL ARTICLE
Joseph B Lerman, Daniel M Guidot, Cynthia L Green, Chetan B Patel, Richa Agarwal, Nancy K Sweitzer, Jeffrey E Keenan, Carmelo A Milano, Jacob N Schroder, Adam D DeVore
No abstract text is available yet for this article.
December 2023: Circulation. Heart Failure
https://read.qxmd.com/read/37669270/successful-aortic-arch-cannulation-and-perfusion-of-a-heart-donated-after-circulatory-death-a-case-report
#7
JOURNAL ARTICLE
Mats T Vervoorn, Paul van Kaam, Mostafa M Mokhles, Niels P van der Kaaij, Monica Gianoli
INTRODUCTION: We describe successful aortic arch cannulation and perfusion of a heart donated after circulatory death using the Transmedics Organ Care System™. CASE REPORT: A 47-year old man developed advanced heart failure symptoms after prior mustard operation for transposition of the great arteries. He matched a DCD-donor and required an elongated aorta for implantation due to his altered anatomy. The donor heart was retrieved and successfully perfused via aortic arch cannulation for 4...
September 5, 2023: Perfusion
https://read.qxmd.com/read/37551611/organ-donation-after-out-of-hospital-cardiac-arrest-a-scientific-statement-from-the-international-liaison-committee-on-resuscitation
#8
REVIEW
Laurie J Morrison, Claudio Sandroni, Brian Grunau, Michael Parr, Finlay Macneil, Gavin D Perkins, Mayuki Aibiki, Eileen Censullo, Steve Lin, Robert W Neumar, Steven C Brooks
AIM OF THE REVIEW: Improving rates of organ donation among patients with out-of-hospital cardiac arrest who do not survive is an opportunity to save countless lives. The objectives of this scientific statement were to do the following: define the opportunity for organ donation among patients with out-of-hospital cardiac arrest; identify challenges and opportunities associated with organ donation by patients with cardiac arrest; identify strategies, including a generic protocol for organ donation after cardiac arrest, to increase the rate and consistency of organ donation from this population; and provide rationale for including organ donation as a key clinical outcome for all future cardiac arrest clinical trials and registries...
September 5, 2023: Circulation
https://read.qxmd.com/read/37511790/transesophageal-echocardiography-guidance-to-prevent-and-manage-pitfalls-from-abdominal-normothermic-regional-perfusion-and-optimize-timing-during-organ-retrieval-from-a-donor-after-circulatory-death
#9
Amedeo Bianchini, Cristiana Laici, Noemi Miglionico, Maria Giacinta Bianchi, Elena Tarozzi, Enrico Bernardi, Jessica Toni, Erika Cordella, Giovanni Vitale, Antonio Siniscalchi
An essential means of collecting more abdominal donor organs is controlled donation after circulatory death (cDCD). The organs are typically preserved during cDCD using the abdominal normothermic regional perfusion (A-NRP) technique to recirculate oxygenated blood flow following cardiac arrest and the withdrawal of life support. One of the challenges of A-NRP is ensuring the correct vascular devices' positionings, specifically extracorporeal membrane oxygenation cannulae and aortic balloons, typically achieved through fluoroscopy with or without contrast agents...
July 24, 2023: Journal of Personalized Medicine
https://read.qxmd.com/read/37492400/confirmatory-digital-subtraction-angiography-after-clinical-brain-death-death-by-neurological-criteria-impact-on-number-of-donors-and-organ-transplants
#10
JOURNAL ARTICLE
Karen Irgens Tanderup Hansen, Jesper Kelsen, Marwan H Othman, Trine Stavngaard, Daniel Kondziella
BACKGROUND: Demand for organs exceeds the number of transplants available, underscoring the need to optimize organ donation procedures. However, protocols for determining brain death (BD)/death by neurological criteria (DNC) vary considerably worldwide. In Denmark, digital subtraction angiography (DSA) is the only legally approved confirmatory test for diagnosing BD/DNC. We investigated the effect of the time delay caused by (repeat) confirmatory DSA on the number of organs donated by patients meeting clinical criteria for BD/DNC...
2023: PeerJ
https://read.qxmd.com/read/37428019/circulating-exosomes-from-brain-death-and-cardiac-death-donors-have-distinct-molecular-and-immunologic-properties-a-pilot-study
#11
JOURNAL ARTICLE
Ranjithkumar Ravichandran, Yoshihiro Itabashi, Fangyu Zhou, Yiing Lin, Thalachallour Mohanakumar, William C Chapman
BACKGROUND AND AIMS: Comparison of donation after brain death (DBD) and donation after cardiac death (DCD) lung tissue before transplantation have demonstrated activation of pro-inflammatory cytokine pathway in DBD donors. The molecular and immunological properties of circulating exosomes from DBD and DCD donors were not previously described. METHODS: We collected plasma from 18 deceased donors (12 DBD and six DCD). Cytokines were analyzed by 30-Plex luminex Panels...
July 10, 2023: Clinical Transplantation
https://read.qxmd.com/read/37421597/successful-transplantation-of-lucas-device-assisted-uncontrolled-dcd-kidneys-with-prolonged-relative-warm-ischemia-time-an-underutilized-option-in-north-america
#12
JOURNAL ARTICLE
Santosh Nagaraju, Rachel Savilla, Myla Moore, Alice Jones, Joseph Africa
Approximately 25% of deceased donors in the United States are procured in a donation after circulatory death (DCD) setting. Successful transplant outcomes from uncontrolled DCD (uDCD) practices have been reported in multiple European programs. They utilize established protocols for uDCD procurement with normo-thermic or hypothermic regional perfusion to reduce ischemic damage. Further, manual or mechanical chest compressions using extrinsic devices, such as the LUCAS device, are implemented to maintain circulation before organ retrieval...
July 8, 2023: Clinical Transplantation
https://read.qxmd.com/read/37314220/current-state-of-cardiac-donation-after-circulatory-death-in-clinical-heart-transplantation
#13
EDITORIAL
Ashish S Shah
No abstract text is available yet for this article.
August 2023: Circulation
https://read.qxmd.com/read/37231075/normothermic-machine-perfusion-versus-static-cold-storage-in-donation-after-circulatory-death-kidney-transplantation-a-randomized-controlled-trial
#14
RANDOMIZED CONTROLLED TRIAL
Sarah A Hosgood, Christopher J Callaghan, Colin H Wilson, Laura Smith, Joanne Mullings, Jennifer Mehew, Gabriel C Oniscu, Benedict L Phillips, Lucy Bates, Michael L Nicholson
Kidney transplantation is the optimal treatment for end-stage renal disease, but it is still severely limited by a lack of suitable organ donors. Kidneys from donation after circulatory death (DCD) donors have been used to increase transplant rates, but these organs are susceptible to cold ischemic injury in the storage period before transplantation, the clinical consequence of which is high rates of delayed graft function (DGF). Normothermic machine perfusion (NMP) is an emerging technique that circulates a warmed, oxygenated red-cell-based perfusate through the kidney to maintain near-physiological conditions...
June 2023: Nature Medicine
https://read.qxmd.com/read/37211334/thoracoabdominal-normothermic-regional-perfusion-in-donation-after-circulatory-death-does-not-restore-brain-blood-flow
#15
JOURNAL ARTICLE
Jennifer A Frontera, Ariane Lewis, Les James, Kara Melmed, Brendan Parent, Eytan Raz, Syed T Hussain, Deane E Smith, Nader Moazami
Use of thoracoabdominal normothermic regional perfusion (TA-NRP) during donation after circulatory death (DCD) is an important advance in organ donation. Prior to establishing TA-NRP, the brachiocephalic, left carotid, and left subclavian arteries are ligated, thereby eliminating anterograde brain blood flow via the carotid and vertebral arteries. While theoretical concerns have been voiced that TA-NRP after DCD may restore brain blood flow via collaterals, there have been no studies to confirm or refute this possibility...
May 19, 2023: Journal of Heart and Lung Transplantation
https://read.qxmd.com/read/37138154/brain-based-arterial-pulse-pressure-threshold-for-death-determination-a-systematic-review
#16
REVIEW
Saptharishi Lalgudi Ganesan, Laura Hornby, Matthew Weiss, Kirk Dawe, Chelsea Lanos, Krista Wollny, Sonny Dhanani, Teneille Gofton
PURPOSE: There is lack of consensus regarding the minimum arterial pulse pressure required for confirming permanent cessation of circulation for death determination by circulatory criteria in organ donors. We assessed direct and indirect evidence supporting whether one should use an arterial pulse pressure of 0 mm Hg vs more than 0 (5, 10, 20, 40) mm Hg to confirm permanent cessation of circulation. SOURCE: We conducted this systematic review as part of a larger project to develop a clinical practice guideline for death determination by circulatory or neurologic criteria...
May 3, 2023: Canadian Journal of Anaesthesia
https://read.qxmd.com/read/37131028/implications-of-the-updated-canadian-death-determination-guidelines-for-organ-donation-interventions-that-restore-circulation-after-determination-of-death-by-circulatory-criteria
#17
JOURNAL ARTICLE
Nicholas B Murphy, Charles Weijer, Marat Slessarev, Jennifer A Chandler, Teneille Gofton
No abstract text is available yet for this article.
May 2, 2023: Canadian Journal of Anaesthesia
https://read.qxmd.com/read/37131027/autoresuscitation-after-circulatory-arrest-an-updated-systematic-review
#18
REVIEW
David J Zorko, Jonah Shemie, Laura Hornby, Gurmeet Singh, Shauna Matheson, Ryan Sandarage, Krista Wollny, Lalida Kongkiattikul, Sonny Dhanani
PURPOSE: Current practice in organ donation after death determination by circulatory criteria (DCD) advises a five-minute observation period following circulatory arrest, monitoring for unassisted resumption of spontaneous circulation (i.e., autoresuscitation). In light of newer data, the objective of this updated systematic review was to determine whether a five-minute observation time was still adequate for death determination by circulatory criteria. SOURCE: We searched four electronic databases from inception to 28 August 2021, for studies evaluating or describing autoresuscitation events after circulatory arrest...
May 2, 2023: Canadian Journal of Anaesthesia
https://read.qxmd.com/read/37131020/a-brain-based-definition-of-death-and-criteria-for-its-determination-after-arrest-of-circulation-or-neurologic-function-in-canada-a-2023-clinical-practice-guideline
#19
JOURNAL ARTICLE
Sam D Shemie, Lindsay C Wilson, Laura Hornby, John Basmaji, Andrew J Baker, Cécile M Bensimon, Jennifer A Chandler, Michaël Chassé, Rosanne Dawson, Sonny Dhanani, Owen T Mooney, Aimee J Sarti, Christy Simpson, Jeanne Teitelbaum, Sylvia Torrance, J Gordon Boyd, Joanne Brennan, Heather Brewster, Robert Carignan, Kirk J Dawe, Christopher J Doig, Kennedy Elliott-Pohl, Teneille E Gofton, Michael Hartwick, Andrew Healey, Kimia Honarmand, Karen Hornby, George Isac, Aly Kanji, Joann Kawchuk, Jennifer A Klowak, Andreas H Kramer, Julie Kromm, Allana E LeBlanc, Katarina Lee-Ameduri, Laurie A Lee, Murdoch Leeies, Ariane Lewis, Alex Manara, Shauna Matheson, Nicole K A McKinnon, Nicholas Murphy, Joel Neves Briard, Thaddeus M Pope, Mypinder S Sekhon, Jai Jai S Shanker, Gurmeet Singh, Jeffrey Singh, Marat Slessarev, Karim Soliman, Stephanie Sutherland, Matthew J Weiss, Randi Zlotnik Shaul, Lionel S Zuckier, David J Zorko, Bram Rochwerg
This 2023 Clinical Practice Guideline provides the biomedical definition of death based on permanent cessation of brain function that applies to all persons, as well as recommendations for death determination by circulatory criteria for potential organ donors and death determination by neurologic criteria for all mechanically ventilated patients regardless of organ donation potential. This Guideline is endorsed by the Canadian Critical Care Society, the Canadian Medical Association, the Canadian Association of Critical Care Nurses, Canadian Anesthesiologists' Society, the Canadian Neurological Sciences Federation (representing the Canadian Neurological Society, Canadian Neurosurgical Society, Canadian Society of Clinical Neurophysiologists, Canadian Association of Child Neurology, Canadian Society of Neuroradiology, and Canadian Stroke Consortium), Canadian Blood Services, the Canadian Donation and Transplantation Research Program, the Canadian Association of Emergency Physicians, the Nurse Practitioners Association of Canada, and the Canadian Cardiovascular Critical Care Society...
April 2023: Canadian Journal of Anaesthesia
https://read.qxmd.com/read/37066850/hyperlactatemia-and-poor-outcome-after-postcardiotomy-veno-arterial-extracorporeal-membrane-oxygenation-an-individual-patient-data-meta-analysis
#20
JOURNAL ARTICLE
Fausto Biancari, Alexander Kaserer, Andrea Perrotti, Vito G Ruggieri, Sung-Min Cho, Jin Kook Kang, Magnus Dalén, Henryk Welp, Kristján Jónsson, Sigurdur Ragnarsson, Francisco J Hernández Pérez, Giuseppe Gatti, Khalid Alkhamees, Antonio Loforte, Andrea Lechiancole, Stefano Rosato, Cristiano Spadaccio, Matteo Pettinari, Giovanni Mariscalco, Timo Mäkikallio, Sebastian D Sahli, Camilla L'Acqua, Amr A Arafat, Monirah A Albabtain, Mohammed M AlBarak, Mohamed Laimoud, Ilija Djordjevic, Ihor Krasivskyi, Robertas Samalavicius, Lina Puodziukaite, Marta Alonso-Fernandez-Gatta, Donat R Spahn, Antonio Fiore
INTRODUCTION: Postcardiotomy veno-arterial extracorporeal membrane oxygenation (V-A-ECMO) is associated with significant mortality. Identification of patients at very high risk for death is elusive and the decision to initiate V-A-ECMO is based on clinical judgment. The prognostic impact of pre-V-A-ECMO arterial lactate level in these critically ill patients has been herein evaluated. METHODS: A systematic review was conducted to identify studies on postcardiotomy VA-ECMO for the present individual patient data meta-analysis...
April 17, 2023: Perfusion
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