Related Experiment Video
Updated: Aug 15, 2025
Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
Simultaneous thoracic and abdominal donation after circulatory death organ recovery: the abdominal surgeon's
Carrie Thiessen1, Steven A Wisel2, Garrett R Roll3
1Division of Transplantation, University of Wisconsin, Madison, Wisconsin.
Insights
Joint donation after circulatory death (DCD) procurement expands access to heart and lung transplants. This review explores technical challenges and solutions for combined thoracic and abdominal DCD organ recovery.
Area of Science:
- Transplantation Immunology
- Surgical Innovation
- Organ Procurement
Background:
- Combined thoracic and abdominal donation after circulatory death (DCD) procurement is becoming standard, increasing access to heart and lung transplants.
- DCD heart procurement methods can delay abdominal organ cooling, raising ischemic injury risks.
- Understanding donor ischemia time effects is crucial for optimizing outcomes in multi-organ DCD.
Approach:
- This review synthesizes international experience with joint DCD procurements.
- It examines technical challenges in simultaneous thoracic and abdominal DCD organ recovery.
- Proposed solutions address donor ischemia and optimize transplant outcomes.
Key Points:
- Normothermic perfusion for DCD hearts can impact abdominal organ viability.
- Strategies to mitigate ischemic injury in abdominal organs during DCD are discussed.
- Optimizing surgical techniques and coordination between procurement teams is essential.
Conclusions:
- Implementing best practices in joint DCD procurement can enhance organ utilization.
- This review provides insights for clinical decision-making and surgical technique refinement.
- Future research directions and policy considerations for DCD organ procurement are outlined.
Purpose Of The Review:
To summarize the international experience with heart-liver (joint) donation after circulatory death (DCD) procurements and to explore the technical challenges in joint abdominal and thoracic DCD procurement.
Recent Findings:
Following completion of the Donors After Circulatory Death Heart Trial in the US, combined thoracic and abdominal DCD is poised to become the standard of care, expanding access to life-saving heart and lung allografts. DCD heart procurement relies on collection of donor blood for priming of the normothermic perfusion pump, which delays cooling of abdominal organs and increases risk of ischemic injury. We review the effect of donor ischemia time on abdominal organs, with several proposed technical solutions to optimize transplant outcomes for all organs.
Summary:
The strategies reviewed in this manuscript may inform clinical decision-making, preoperative coordination between thoracic and abdominal procurement teams, and surgical technique for joint DCD procurements. Several approaches to organ procurement organization (OPO) and national policy, as well as future areas of focus for research are proposed.
