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Updated: Jan 24, 2026

Large-Animal Model of Donation after Circulatory Death and Normothermic Regional Perfusion for Cardiac Assessment
Published on: May 10, 2022
Neuromonitoring during heart retrieval using thoracoabdominal normothermic regional perfusion: A prospective cohort
Ana Tur1, Elaine Lo2, Iván Martín-González3
1Department of Anesthesiology and Surgical-Trauma Intensive Care, Hospital Politècnic i Universitari La Fe, Valencia, Spain.
Abstract:
We conducted a prospective consecutive-patient neuromonitoring trial to assess brain function and flow during heart retrieval using thoracoabdominal normothermic regional perfusion (TA-NRP). Bispectral Index (BIS), quantitative pupillometry, and transcranial Doppler (TCD) were employed at multiple timepoints including: 1) before withdrawal of life-sustaining treatments (WLST) and 2) after exclusion of the circulation to the brain and TA-NRP initiation at 3-time intervals: 1, 5, and 10 min. A total of 43 TANRP heart donors were included in this study. Post-NRP initiation, neurological pupil index (NPI) was 0 for both pupils for all donors. TCD showed flow in at least one vessel for all donors prior to WLST and no flow in any vessel for all donors post-NRP. Median BIS was 31 (24, 37) before WLST and reached 0 for all donors post-NRP. Larger-scale multicenter studies are needed to definitively confirm these findings. Such validation is essential for providing necessary reassurance that TA-NRP does not restore brain blood flow nor brain functions.
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