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Updated: Sep 16, 2025
Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
Thoracoabdominal Normothermic Regional Perfusion: Technical Tips for Abdominal Transplant Surgeons
Maria Baimas-George1, Rashikh Choudhury1, Marissa Di Napoli1
1Department of Surgery, Abdominal Transplantation, University of Colorado, Aurora, Colorado; Colorado Center for Transplantation Care, Research, and Education, University of Colorado, Aurora, Colorado.
Normothermic regional perfusion (NRP) enhances organ utilization from donation after circulatory death (DCD) donors. This technique mitigates ischemic injury, improving outcomes and expanding the donor pool for life-saving transplants.
Area of Science:
- Transplantation Surgery
- Organ Procurement
- Cardiopulmonary Resuscitation
Background:
- Donation after circulatory death (DCD) historically had limited graft utilization due to complications.
- Normothermic regional perfusion (NRP) is a novel technique for in situ perfusion after circulatory death.
- NRP minimizes ischemic injury compared to traditional cold perfusion methods.
Purpose of the Study:
- To evaluate the clinical outcomes and feasibility of NRP in DCD organ procurement.
- To highlight the potential of NRP to expand the donor pool.
- To provide guidance on thoracic cannulation techniques for NRP.
Main Methods:
- NRP involves a multidisciplinary team including perfusionists and transplant surgeons.
- Key procedural steps include sternotomy, cannulation, and initiation of perfusion.
- Meticulous team communication and organized setup are critical for successful NRP.
Main Results:
- Since October 2022, 128 NRP attempts were made in DCD cases.
- 108 DCD donors progressed to cardiac death under NRP.
- 94 liver transplants were successfully performed using organs from NRP-supported DCD donors.
Conclusions:
- Thoracic cannulation for NRP presents unique challenges, especially for abdominal transplant surgeons.
- Evolving techniques and strategies have led to reliable and successful NRP outcomes.
- This review offers practical tips and addresses potential pitfalls in thoracic NRP cannulation.
