Direct Procurement of Heart and Lungs from a Controlled DCD Donor with Ongoing Abdominal Normothermic Regional Perfusion (aNRP) – A Synchronized Retrieval
1Department of Cardiothoracic Surgery, Transplantation and MCS, Royal Brompton & Harefield Hospitals Part of Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom, 2Department of Heart and Lung Transplant, Royal Papworth Hospital, Cambridge, United Kingdom, 3Roy Calne Transplant Unit, Department of Surgery, Addenbrookes Hospital, Cambridge University NHS Trust, Cambridge, United Kingdom, 4Edinburgh Transplant Centre, Royal Infirmary of Edinburgh, Edinburgh, Edinburgh, United Kingdom, 5Edinburgh Transplant Centre, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
Meeting: 2022 American Transplant Congress
Abstract number: 1787
Keywords: Donation, Heart/lung transplantation, Outcome, Procurement
Topic: Clinical Science » Organ Inclusive » 68 - Deceased Donor Management and Intervention Research
Session Information
Session Name: Deceased Donor Management and Intervention Research
Session Type: Poster Abstract
Date: Tuesday, June 7, 2022
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Halls C & D
*Purpose: With the increased number of aNRP in controlled DCD donors comes a high demand for techniques to directly procure cardiothoracic organs during the aNRP. This combined procedure is very challenging. In the UK antemortem administration of heparin, wire or cannula insertion are not allowed. In recent years we have developed a nationally recognized direct procurement technique, which requires surgical skills and a crucial harmonic synchronization between the two cardiothoracic surgeons and the abdominal retrieval team.
*Methods: Figure 1: Theater setup. CTS: cardiothoracic surgeon, AS: abdominal surgeon, OCS: organ care system, SNOD: specialist nurse organ donation*1) Groin cannulation then 2) laparotomy
The instruments must be organized according to the scrub trolley discipline requiring a structured and chronologic layout matching the surgical steps. Figure 2: Summarized surgical steps. Each surgeon has a specific role to play in the synchronization.
*Results: Since October 2019 we have performed 9 such retrievals. All of them were uninterrupted and successful; there was no loss of organs.
*Conclusions: Direct procurement of cardiothoracic organs from controlled DCD donors with ongoing aNRP is a challenging procedure. Following a steep learning curve, we developed and implemented a national retrieval protocol. Oustanding communication and synchronization of the thoracic and abdominal teams results in a successful retrieval and optimal organ utilization.
To cite this abstract in AMA style:
Husain M, Jothidasan A, Zeschky C, Osman M, Berman M, Gaurav R, Butler A, Watson C, Stutchfield B, Currie I, Oniscu G, Dunning J, Stock U. Direct Procurement of Heart and Lungs from a Controlled DCD Donor with Ongoing Abdominal Normothermic Regional Perfusion (aNRP) – A Synchronized Retrieval [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/direct-procurement-of-heart-and-lungs-from-a-controlled-dcd-donor-with-ongoing-abdominal-normothermic-regional-perfusion-anrp-a-synchronized-retrieval/. Accessed May 9, 2025.« Back to 2022 American Transplant Congress