Evaluation of functional warm ischemia time during controlled donation after circulatory determination of death using normothermic regional perfusion (ECMO-TT): A prospective multicenter cohort study

Background: Controlled donation after circulatory determination of death (cDCD) seems an effective way to mitigate the critical shortage of available organs for transplant worldwide. As a recently developed procedure for organ retrieval, some questions remain unsolved such as the uncertainty regardi...

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Autores: Martinez-Castro, Sara, Navarro, Rosalia, Garcia-Perez, Maria Luisa, Segura, Jose Manuel, Carbonell, Jose A, Hornero, Fernando, Guijarro, Jorge, Zaplana, Marta, Bruno, Maria Angeles, Tur, Ana, Martinez-Leon, Juan Bautista, Zaragoza, Rafael, Nunez, Julio, Dominguez-Gil, Beatriz, Badenes, Rafael
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Recursos:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p17413
Acesso em linha:https://incliva.portalinvestigacion.com/publicaciones/17413
Access Level:acceso abierto
Palavra-chave:controlled donation after circulatory determination of death
extracorporeal membrane oxygenation
normothermic regional perfusion
organ transplantation
withdrawal of life-sustaining therapy
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spelling Evaluation of functional warm ischemia time during controlled donation after circulatory determination of death using normothermic regional perfusion (ECMO-TT): A prospective multicenter cohort studyMartinez-Castro, SaraNavarro, RosaliaGarcia-Perez, Maria LuisaSegura, Jose ManuelCarbonell, Jose AHornero, FernandoGuijarro, JorgeZaplana, MartaBruno, Maria AngelesTur, AnaMartinez-Leon, Juan BautistaZaragoza, RafaelNunez, JulioDominguez-Gil, BeatrizBadenes, Rafaelcontrolled donation after circulatory determination of deathextracorporeal membrane oxygenationnormothermic regional perfusionorgan transplantationwithdrawal of life-sustaining therapyBackground: Controlled donation after circulatory determination of death (cDCD) seems an effective way to mitigate the critical shortage of available organs for transplant worldwide. As a recently developed procedure for organ retrieval, some questions remain unsolved such as the uncertainty regarding the effect of functional warm ischemia time (FWIT) on organs viability. Methods: We developed a multicenter prospective cohort study collecting all data from evaluated organs during cDCD from 2017 to 2020. All the procedures related to cDCD were performed with normothermic regional perfusion. The analysis included organ retrieval as endpoint and FWIT as exposure of interest. The effect of FWIT on the likelihood for organ retrieval was evaluated with Relative distribution analysis. Results: A total amount of 507 organs ' related information was analyzed from 95 organ donors. Median donor age was 62 years, and 63% of donors were male. Stroke was the most common diagnosis before withdrawal of life-sustaining therapy (61%), followed by anoxic encephalopathy (21%). This analysis showed that length of FWIT was inversely associated with organ retrieval rates for liver, kidneys, and pancreas. No statistically significant association was found for lungs. Conclusions: Results showed an inverse association between functional warm ischemia time (FWIT) and retrieval rate. We also have postulated optimal FWIT's thresholds for organ retrieval. FWIT for liver retrieval remained between 6 and less than 11 min and in case of kidneys and pancreas, the optimal FWIT for retrieval was 6 to 12 min. These results could be valuable to improve organ utilization and for future analysis.WILEY2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://incliva.portalinvestigacion.com/publicaciones/17413ARTIFICIAL ORGANSISSN: 0160564XISSNe: 15251594reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVAinstname:INCLIVAInglésinfo:eu-repo/semantics/openAccessoai:incliva.fundanetsuite.com:p174132026-06-07T16:35:31Z
dc.title.none.fl_str_mv Evaluation of functional warm ischemia time during controlled donation after circulatory determination of death using normothermic regional perfusion (ECMO-TT): A prospective multicenter cohort study
title Evaluation of functional warm ischemia time during controlled donation after circulatory determination of death using normothermic regional perfusion (ECMO-TT): A prospective multicenter cohort study
spellingShingle Evaluation of functional warm ischemia time during controlled donation after circulatory determination of death using normothermic regional perfusion (ECMO-TT): A prospective multicenter cohort study
Martinez-Castro, Sara
controlled donation after circulatory determination of death
extracorporeal membrane oxygenation
normothermic regional perfusion
organ transplantation
withdrawal of life-sustaining therapy
title_short Evaluation of functional warm ischemia time during controlled donation after circulatory determination of death using normothermic regional perfusion (ECMO-TT): A prospective multicenter cohort study
title_full Evaluation of functional warm ischemia time during controlled donation after circulatory determination of death using normothermic regional perfusion (ECMO-TT): A prospective multicenter cohort study
title_fullStr Evaluation of functional warm ischemia time during controlled donation after circulatory determination of death using normothermic regional perfusion (ECMO-TT): A prospective multicenter cohort study
title_full_unstemmed Evaluation of functional warm ischemia time during controlled donation after circulatory determination of death using normothermic regional perfusion (ECMO-TT): A prospective multicenter cohort study
title_sort Evaluation of functional warm ischemia time during controlled donation after circulatory determination of death using normothermic regional perfusion (ECMO-TT): A prospective multicenter cohort study
dc.creator.none.fl_str_mv Martinez-Castro, Sara
Navarro, Rosalia
Garcia-Perez, Maria Luisa
Segura, Jose Manuel
Carbonell, Jose A
Hornero, Fernando
Guijarro, Jorge
Zaplana, Marta
Bruno, Maria Angeles
Tur, Ana
Martinez-Leon, Juan Bautista
Zaragoza, Rafael
Nunez, Julio
Dominguez-Gil, Beatriz
Badenes, Rafael
author Martinez-Castro, Sara
author_facet Martinez-Castro, Sara
Navarro, Rosalia
Garcia-Perez, Maria Luisa
Segura, Jose Manuel
Carbonell, Jose A
Hornero, Fernando
Guijarro, Jorge
Zaplana, Marta
Bruno, Maria Angeles
Tur, Ana
Martinez-Leon, Juan Bautista
Zaragoza, Rafael
Nunez, Julio
Dominguez-Gil, Beatriz
Badenes, Rafael
author_role author
author2 Navarro, Rosalia
Garcia-Perez, Maria Luisa
Segura, Jose Manuel
Carbonell, Jose A
Hornero, Fernando
Guijarro, Jorge
Zaplana, Marta
Bruno, Maria Angeles
Tur, Ana
Martinez-Leon, Juan Bautista
Zaragoza, Rafael
Nunez, Julio
Dominguez-Gil, Beatriz
Badenes, Rafael
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv controlled donation after circulatory determination of death
extracorporeal membrane oxygenation
normothermic regional perfusion
organ transplantation
withdrawal of life-sustaining therapy
topic controlled donation after circulatory determination of death
extracorporeal membrane oxygenation
normothermic regional perfusion
organ transplantation
withdrawal of life-sustaining therapy
description Background: Controlled donation after circulatory determination of death (cDCD) seems an effective way to mitigate the critical shortage of available organs for transplant worldwide. As a recently developed procedure for organ retrieval, some questions remain unsolved such as the uncertainty regarding the effect of functional warm ischemia time (FWIT) on organs viability. Methods: We developed a multicenter prospective cohort study collecting all data from evaluated organs during cDCD from 2017 to 2020. All the procedures related to cDCD were performed with normothermic regional perfusion. The analysis included organ retrieval as endpoint and FWIT as exposure of interest. The effect of FWIT on the likelihood for organ retrieval was evaluated with Relative distribution analysis. Results: A total amount of 507 organs ' related information was analyzed from 95 organ donors. Median donor age was 62 years, and 63% of donors were male. Stroke was the most common diagnosis before withdrawal of life-sustaining therapy (61%), followed by anoxic encephalopathy (21%). This analysis showed that length of FWIT was inversely associated with organ retrieval rates for liver, kidneys, and pancreas. No statistically significant association was found for lungs. Conclusions: Results showed an inverse association between functional warm ischemia time (FWIT) and retrieval rate. We also have postulated optimal FWIT's thresholds for organ retrieval. FWIT for liver retrieval remained between 6 and less than 11 min and in case of kidneys and pancreas, the optimal FWIT for retrieval was 6 to 12 min. These results could be valuable to improve organ utilization and for future analysis.
publishDate 2023
dc.date.none.fl_str_mv 2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://incliva.portalinvestigacion.com/publicaciones/17413
url https://incliva.portalinvestigacion.com/publicaciones/17413
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv WILEY
publisher.none.fl_str_mv WILEY
dc.source.none.fl_str_mv ARTIFICIAL ORGANS
ISSN: 0160564X
ISSNe: 15251594
reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
instname:INCLIVA
instname_str INCLIVA
reponame_str r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
collection r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,198674

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