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Extracorporeal membrane oxygenation support in potential organ donors for brain death determination
1Department of General Surgery, Changhua Christian Hospital, Changhua, Taiwan.
Background:
Extracorporeal membrane oxygenation (ECMO) must be applied in early stages to perfuse organs before donation in order to expand the donor pool. The aim of this study was to examine the benefits of ECMO for potential organ donors with multiple complications.
Materials And Methods:
This retrospective review describes patients with ECMO support who were on the verge of brain death and therefore potential subjects for organ donation.
Results:
Six organ donors with severe neurological damage under ECMO support completed the procedures, namely, two women and four men of ages 19 to 58 years (mean, 32 years). Three donors completed the brain-death determination procedure, one failed the procedure, and two experienced cardiac asystole prior to the procedure and were unable to be declared dead even after resuscitation. Nine kidneys and three livers were successfully retrieved from 5/6 donors, leading to 11 successful transplantations: eight kidneys, two livers, and one simultaneous kidney-liver transplantations. The organs functioned well and the recipients made full recoveries.
Conclusions:
ECMO allows for the maintenance of abdominal organ tissue perfusion without warm ischemia before organ procurement, providing sufficient time for safe organ donation procedures and reducing the risk of unpredictable cardiac arrest that could result in the donor death and graft loss.
