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- W2331749690 abstract "Donation after circulatory determined death (DCD) donor hearts are currently not considered for transplantation as there is no reliable method to assess function following an obligatory warm ischaemic period. We explored the feasibility of in-situ reperfusion of human DCD hearts using extra corporeal membrane oxygenation (ECMO) and compared functional assessment on a modified TransMedics Organ Care System (OCS) in working mode. Following next of kin consent, treatment was withdrawn from 6 patients with severe brain injury and 3 proceeded to be DCD donors. Following declaration of death a sternotomy was performed. The aortic arch vessels were clamped and central ECMO was instituted. After cardiac function had been restored, ECMO was weaned and functional assessment was undertaken with thermodilution cardiac output studies and load independent indices derived from pressure-volume loops. The hearts were then explanted and instrumented on the OCS before further functional assessment in working mode. All proceeding donors were reperfused upon ECMO within 12 minutes following declaration of death. Following reperfusion donor 1 could be weaned from ECMO, donor 2 required dopamine (D) and further ECMO support prior to procurement and donor 3 required dopamine only. When comparing functional assessment within the donor and ex vivo, donor 2 had consistently inferior systolic function and low inotropic reserve in comparison to the other hearts studied which would not have been detected without functional evaluation. It is feasible to reperfuse DCD donor hearts with central ECMO to minimise warm ischaemic time. In-situ functional assessment of DCD donor hearts following reperfusion and ex vivo assessment in the modified OCS can both provide consistent information prior to transplantation." @default.
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- W2331749690 date "2015-04-01" @default.
- W2331749690 modified "2023-09-27" @default.
- W2331749690 title "Restoring Function to the DCD Human Heart Using ECMO Followed By Transportation and Functional Assessment on the TransMedics Organ Care System" @default.
- W2331749690 doi "https://doi.org/10.1016/j.healun.2015.01.779" @default.
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