Complex Donor Transfer and Organ Procurement Organization Collaboration to Reduce Ischemia Time in Combined Face and Bilateral Hand Transplant
1Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, 2Transplant Institute, NYU Langone Health, New York, NY
Meeting: 2022 American Transplant Congress
Abstract number: 956
Keywords: Allocation, Resource utilization, Safety, Warm ischemia
Topic: Basic & Clinical Science » Basic & Clinical Science » 20 - VCA
Session Information
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: We present a complex donor transfer protocol that places the donor at the recipient hospital prior to allograft procurement in order to reduce ischemia time.
*Methods: An ideal donor was identified approximately 100 miles from our institution. The recipient was a 22-year-old male who sustained extensive burns in a motor vehicle accident. Through careful collaboration with both local (LiveOnNY) and nonlocal (Gift of Life) organ procurement organizations, donor transfer was arranged via helicopter to our institution. This involved a preliminary evaluation at the donor hospital, further evaluations at our institution to finalize the operative plan, and execution in adjacent operating rooms by a team of surgeons that had thoroughly rehearsed the procedure.
*Results: Timestamps are in relation to commencement of the transplant procedure. The senior surgeons arrived at the donor hospital for preliminary evaluation at -34 hours, with transfer to our institution occurring at -32 hours. Upon arrival at -31 hours, the donor was transferred to the post-anesthesia care unit for anesthesia evaluation. Tracheostomy placement occurred at -29.5 hours, followed by placement of femoral lines. Further evaluations included computed tomography (CT) angiography (-28 hours) and interventional angiography (-26.5 hours). The donor’s face and hands were scanned to create a face mask and hand prostheses for family memorial arrangements (-24 hours). Transplantation commenced at 6:00 am on August 12, 2020. Total ischemia times were 2 hours, 52 minutes; 3 hours, 30 minutes; and 2 hours, 46 minutes for the facial, right hand, and left hand allografts, respectively. A representative from Gift of Life was present with the donor all throughout.
*Conclusions: Minimization of ischemia time is critical for success in vascularized composite allotransplantation. Through careful collaboration with organ procurement organizations, we executed a complex donor transfer protocol that placed an ideal, nonlocal donor and the recipient in adjacent operating rooms without compromising the donor safety standards set by organ procurement organizations.
To cite this abstract in AMA style:
Trilles J, Boczar D, Chaya BF, Berman ZP, Diep GK, Colon RRodriguez, Ceradini DJ, Rodriguez ED, Gelb BE. Complex Donor Transfer and Organ Procurement Organization Collaboration to Reduce Ischemia Time in Combined Face and Bilateral Hand Transplant [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/complex-donor-transfer-and-organ-procurement-organization-collaboration-to-reduce-ischemia-time-in-combined-face-and-bilateral-hand-transplant/. Accessed May 18, 2025.« Back to 2022 American Transplant Congress