Thoracic organ donation after circulatory determination of death

Sanaz Hatami; Jennifer Conway; Darren H. Freed; Simon Urschel

Transplantation Reports (Feb 2023)

Thoracic organ donation after circulatory determination of death

Sanaz Hatami,
Jennifer Conway,
Darren H. Freed,
Simon Urschel

Affiliations

Sanaz Hatami: Department of Medicine, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute, Edmonton, AB, Canada
Jennifer Conway: Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
Darren H. Freed: Department of Physiology, University of Alberta, Edmonton, AB, Canada; Biomedical Engineering, University of Alberta, Edmonton, AB, Canada; Department of Surgery, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute, Edmonton, AB, Canada; Canadian Transplant Research Program, Canada
Simon Urschel: Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Alberta Transplant Institute, Edmonton, AB, Canada; Canadian Transplant Research Program, Canada; Corresponding author at: Medical Microbiology and Immunology, Director of Pediatric Cardiac Transplantation, 1) Division of Pediatric Cardiology, Department of Pediatrics, Alberta Transplant Institute, University of Alberta/Stollery Children's Hospital, 4C2.24, Walter McKenzie Center, 8440 - 112 Street, Edmonton, AB, T6G 2B7, Canada

Journal volume & issue: Vol. 8, no. 1
p. 100125

Abstract

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The availability of thoracic organ transplantation as the treatment of choice for end-stage cardiac or pulmonary diseases is limited by the insufficient number of donor organs from brain dead donors, especially for organs where live-donation is not an option. Patients, who have not progressed to brain death, but have exhausted therapeutic options and life sustaining therapies are withdrawn can become donors with circulatory determination of death (DCD) when they meet criteria for the definition of this state. This approach can fulfill the wish of a patient to become an organ donor and also help to increase the number of donor organs. The DCD process exposes organs to prolonged warm ischemia that increases the possibility of primary graft dysfunction and failure. However, new technologies help in protecting the organs from cold preservation-related ischemia and facilitate resuscitation and monitoring of viability after the occurrence of the DCD-related ischemic insult. Herein, we review the opportunities and challenges in DCD thoracic organ transplantation, emerging techniques in preservation and monitoring of these organs and the potential effect of DCD thoracic organ transplantation on expanding the donor pool.

Published in Transplantation Reports

ISSN: 2451-9596 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: https://www.journals.elsevier.com/transplantation-reports/

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