BACKGROUND: Extracorporeal membrane oxygenation (ECMO) must be applied in early stages to perfuse organs before donation in order to expand the donor pool. The aim of this study was to examine the benefits of ECMO for potential organ donors with multiple complications. MATERIALS AND METHODS: This retrospective review describes patients with ECMO support who were on the verge of brain death and therefore potential subjects for organ donation. RESULTS: Six organ donors with severe neurological damage under ECMO support completed the procedures, namely, two women and four men of ages 19 to 58 years (mean, 32 years). Three donors completed the brain-death determination procedure, one failed the procedure, and two experienced cardiac asystole prior to the procedure and were unable to be declared dead even after resuscitation. Nine kidneys and three livers were successfully retrieved from 5/6 donors, leading to 11 successful transplantations: eight kidneys, two livers, and one simultaneous kidney-liver transplantations. The organs functioned well and the recipients made full recoveries. CONCLUSIONS: ECMO allows for the maintenance of abdominal organ tissue perfusion without warm ischemia before organ procurement, providing sufficient time for safe organ donation procedures and reducing the risk of unpredictable cardiac arrest that could result in the donor death and graft loss.
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) must be applied in early stages to perfuse organs before donation in order to expand the donor pool. The aim of this study was to examine the benefits of ECMO for potential organ donors with multiple complications. MATERIALS AND METHODS: This retrospective review describes patients with ECMO support who were on the verge of brain death and therefore potential subjects for organ donation. RESULTS: Six organ donors with severe neurological damage under ECMO support completed the procedures, namely, two women and four men of ages 19 to 58 years (mean, 32 years). Three donors completed the brain-death determination procedure, one failed the procedure, and two experienced cardiac asystole prior to the procedure and were unable to be declared dead even after resuscitation. Nine kidneys and three livers were successfully retrieved from 5/6 donors, leading to 11 successful transplantations: eight kidneys, two livers, and one simultaneous kidney-liver transplantations. The organs functioned well and the recipients made full recoveries. CONCLUSIONS: ECMO allows for the maintenance of abdominal organ tissue perfusion without warm ischemia before organ procurement, providing sufficient time for safe organ donation procedures and reducing the risk of unpredictable cardiac arrest that could result in the donordeath and graft loss.
Authors: Paolo Balsorano; Marco Ciapetti; Giovanni Cianchi; Manuela Bonizzoli; Maria Luisa Migliaccio; Maria Cristina Ferraro; Andrea Franci; Adriano Peris Journal: Int J Surg Case Rep Date: 2015-03-04
Authors: Marilena Gregorini; Elena Ticozzelli; Massimo Abelli; Maria A Grignano; Eleonora F Pattonieri; Alessandro Giacomoni; Luciano De Carlis; Antonio Dell'Acqua; Rossana Caldara; Carlo Socci; Andrea Bottazzi; Carmelo Libetta; Vincenzo Sepe; Stefano Malabarba; Federica Manzoni; Catherine Klersy; Giuseppe Piccolo; Teresa Rampino Journal: Transpl Int Date: 2022-02-08 Impact factor: 3.782