Endovascular aortic crossclamp: a novel way to reduce warm ischemia time in DCD donors

Area of Science:

• Transplantation Surgery
• Organ Donation
• Vascular Interventions

Background:

• Donation after cardiac death (DCD) increases organ supply but faces challenges with warm ischemia time (WIT).
• Minimizing WIT is crucial for improving organ function, graft survival, and patient outcomes.
• Prolonged WIT can lead to organ discard and reduced transplant success.

Purpose of the Study:

• To describe and evaluate a novel endovascular aortic crossclamping technique in DCD donors.
• To assess the impact of this technique on reducing WIT.
• To determine the feasibility and effectiveness of the endovascular approach in preserving organ quality.

Main Methods:

• A novel endovascular aortic crossclamping technique was implemented in DCD donors.
• Organ recovery included six kidneys and two livers from three donors.
• Mean WIT was measured from extubation to aortic crossclamp, and time from initial glidewire placement to crossclamp was recorded.

Main Results:

• Mean WIT from extubation to aortic crossclamp was 25 ± 8 minutes.
• The endovascular crossclamp was achieved in less than 2 minutes from glidewire placement.
• All recovered organs were adequately flushed, with no signs of thrombosis upon examination.

Conclusions:

• The endovascular aortic crossclamping technique is a novel and feasible method to decrease WIT in DCD donors.
• This technique can potentially reduce organ discard rates and improve transplant outcomes.
• Manipulating WIT after cardiac arrest is achievable with innovative endovascular approaches.