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Abdominal regional in-situ perfusion in donation after circulatory determination of death donors

Hessheimer, Amelia J.; García-Valdecasas, Juan C.; Fondevila, Constantino

Current Opinion in Organ Transplantation: June 2016 - Volume 21 - Issue 3 - p 322–328
doi: 10.1097/MOT.0000000000000315
REVIEW
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Purpose of review Provide an overview regarding the current state of abdominal regional perfusion (ARP) in donation after circulatory determination of death (DCD) organ transplantation, including the principles behind how ARP functions and the most recent results of its clinical application.

Recent findings ARP has been applied clinically in DCD at both hypothermic and normothermic temperatures. The use of hypothermic perfusion has primarily been limited to DCD kidney transplantation, whereas normothermic regional perfusion has been used to improve and assess the quality of DCD kidneys, livers, and even a handful of pancreata for transplantation. Results of recent single-center series reflect acceptable rates of early graft function and survival using grafts that might have otherwise been discarded.

Summary ARP is an important form of donor maintenance that helps improve DCD organ viability and may help expand the applicability of transplantation using organs arising through this process.

General and Digestive Surgery, Institut de Malalties Digestives i Metabòliques (IMDiM), Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Spain

Correspondence to Constantino Fondevila, MD, PhD, Hepatobiliary and Liver Transplant Surgery, Hospital Clínic, University of Barcelona, C/ Villarroel 170, 08036 Barcelona, Spain. Tel: +34 93 227 57 18; fax: +34 93 227 55 89; e-mail: cfonde@clinic.ub.es

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