Liver and Kidney Transplantation from Donation After Circulatory Death Heart Donors in the US: Better Early Outcomes with Normothermic Regional Perfusion versus Cold Flush
1Baylor University Medical Center, Dallas, TX, 2Baylor University Medical Center, Fort Worth, TX, 3Baylor Dallas, Dallas, TX
Meeting: 2022 American Transplant Congress
Abstract number: 906
Keywords: Allocation, Circulatory Death, Donors, non-heart-beating, Perfusion
Topic: Clinical Science » Organ Inclusive » 69 - Non-Organ Specific:Organ Preservation/Ischemia Reperfusion Injury
Session Information
Session Name: Non-Organ Specific: Organ Preservation/Ischemia Reperfusion Injury
Session Type: Poster Abstract
Date: Saturday, June 4, 2022
Session Time: 5:30pm-7:00pm
Presentation Time: 5:30pm-7:00pm
Location: Hynes Halls C & D
Session Information
Session Time: 7:00pm-8:00pm
Presentation Time: 7:00pm-8:00pm
Location: Hynes Hall C
*Purpose: Donation after circulatory death (DCD) heart donation is increasingly common in the US. The two methods for DCD heart donation are normothermic regional perfusion (TA-NRP) and cold flush with ex-vivo heart machine perfusion (CF-MP). Liver and kidney transplant outcomes after TA-NRP DCD have shown promise outside the US but have not been reported in the US.
*Methods: All successful DCD heart donors from October 1, 2020 to September 30, 2021 were identified in the UNOS Star file database. Death to cross-clamp time was used to distinguish between TA-NRP DCD donors (>15 minutes) and CF-MP DCD donors (<15 minutes). Groups were compared with bivariate analysis.
*Results: Other than death to cross-clamp time, donor characteristics were similar among the two donor groups except CF-MP donors had a higher median age (31 vs 27) and kidney donor profile index (29% versus 19%). The delayed graft function rate for CF-MP donors was higher than TA-NRP donors (42.9% versus 12.5%). There were no significant differences in liver transplant recipient outcomes. 2 liver recipients of CF-MP DCD donors had early graft failures requiring re-transplantation versus none of the TA-NRP DCD recipients. No ischemic cholangiopathy was reported in either group.
*Conclusions: We found that the rates of delayed kidney graft function were significantly higher with CF-MP DCD donors as compared to TA-NRP DCD donors ad that two of the CF-MP recipients required early re-transplantation as compared to none of the TA-NRP recipients. Longer term follow-up is needed to determine if there are differences in biliary complication rates, especially ischemic cholangiopathy.
To cite this abstract in AMA style:
Rosenzweig M, Ruiz R, Martinez E, Gupta A, Fernandez H, Lee S, Onaca N, Bayer J, McKenna GJ, Ma T, Testa G, Wall A. Liver and Kidney Transplantation from Donation After Circulatory Death Heart Donors in the US: Better Early Outcomes with Normothermic Regional Perfusion versus Cold Flush [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/liver-and-kidney-transplantation-from-donation-after-circulatory-death-heart-donors-in-the-us-better-early-outcomes-with-normothermic-regional-perfusion-versus-cold-flush/. Accessed December 2, 2024.« Back to 2022 American Transplant Congress