Cargando…

Transesophageal Echocardiography Guidance to Prevent and Manage Pitfalls from Abdominal Normothermic Regional Perfusion and Optimize Timing during Organ Retrieval from a Donor after Circulatory Death

An essential means of collecting more abdominal donor organs is controlled donation after circulatory death (cDCD). The organs are typically preserved during cDCD using the abdominal normothermic regional perfusion (A-NRP) technique to recirculate oxygenated blood flow following cardiac arrest and t...

Descripción completa

Detalles Bibliográficos
Autores principales: Bianchini, Amedeo, Laici, Cristiana, Miglionico, Noemi, Bianchi, Maria Giacinta, Tarozzi, Elena, Bernardi, Enrico, Toni, Jessica, Cordella, Erika, Vitale, Giovanni, Siniscalchi, Antonio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381753/
https://www.ncbi.nlm.nih.gov/pubmed/37511790
http://dx.doi.org/10.3390/jpm13071177
_version_ 1785080521916678144
author Bianchini, Amedeo
Laici, Cristiana
Miglionico, Noemi
Bianchi, Maria Giacinta
Tarozzi, Elena
Bernardi, Enrico
Toni, Jessica
Cordella, Erika
Vitale, Giovanni
Siniscalchi, Antonio
author_facet Bianchini, Amedeo
Laici, Cristiana
Miglionico, Noemi
Bianchi, Maria Giacinta
Tarozzi, Elena
Bernardi, Enrico
Toni, Jessica
Cordella, Erika
Vitale, Giovanni
Siniscalchi, Antonio
author_sort Bianchini, Amedeo
collection PubMed
description An essential means of collecting more abdominal donor organs is controlled donation after circulatory death (cDCD). The organs are typically preserved during cDCD using the abdominal normothermic regional perfusion (A-NRP) technique to recirculate oxygenated blood flow following cardiac arrest and the withdrawal of life support. One of the challenges of A-NRP is ensuring the correct vascular devices’ positionings, specifically extracorporeal membrane oxygenation cannulae and aortic balloons, typically achieved through fluoroscopy with or without contrast agents. Here, we present a case report in which transesophageal echocardiography (TEE) helped the transplant team to effectively procure viable abdominal organs from a cDCD donor in the shortest time frame, as minimizing time is one of the most crucial factors in maintaining organ viability. TEE use leads to a more effective and efficient A-NRP procedure with limited complications. In addition, it allows us to observe the circulation of both the thoracic and part of the abdominal organs using one fast exam. This case is the first report describing TEE as a primary guide and useful tool for DCD donors. However, prospective studies are needed to confirm that TEE could be used as standard practice during all DCD organ retrieval procedures.
format Online
Article
Text
id pubmed-10381753
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-103817532023-07-29 Transesophageal Echocardiography Guidance to Prevent and Manage Pitfalls from Abdominal Normothermic Regional Perfusion and Optimize Timing during Organ Retrieval from a Donor after Circulatory Death Bianchini, Amedeo Laici, Cristiana Miglionico, Noemi Bianchi, Maria Giacinta Tarozzi, Elena Bernardi, Enrico Toni, Jessica Cordella, Erika Vitale, Giovanni Siniscalchi, Antonio J Pers Med Case Report An essential means of collecting more abdominal donor organs is controlled donation after circulatory death (cDCD). The organs are typically preserved during cDCD using the abdominal normothermic regional perfusion (A-NRP) technique to recirculate oxygenated blood flow following cardiac arrest and the withdrawal of life support. One of the challenges of A-NRP is ensuring the correct vascular devices’ positionings, specifically extracorporeal membrane oxygenation cannulae and aortic balloons, typically achieved through fluoroscopy with or without contrast agents. Here, we present a case report in which transesophageal echocardiography (TEE) helped the transplant team to effectively procure viable abdominal organs from a cDCD donor in the shortest time frame, as minimizing time is one of the most crucial factors in maintaining organ viability. TEE use leads to a more effective and efficient A-NRP procedure with limited complications. In addition, it allows us to observe the circulation of both the thoracic and part of the abdominal organs using one fast exam. This case is the first report describing TEE as a primary guide and useful tool for DCD donors. However, prospective studies are needed to confirm that TEE could be used as standard practice during all DCD organ retrieval procedures. MDPI 2023-07-24 /pmc/articles/PMC10381753/ /pubmed/37511790 http://dx.doi.org/10.3390/jpm13071177 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Bianchini, Amedeo
Laici, Cristiana
Miglionico, Noemi
Bianchi, Maria Giacinta
Tarozzi, Elena
Bernardi, Enrico
Toni, Jessica
Cordella, Erika
Vitale, Giovanni
Siniscalchi, Antonio
Transesophageal Echocardiography Guidance to Prevent and Manage Pitfalls from Abdominal Normothermic Regional Perfusion and Optimize Timing during Organ Retrieval from a Donor after Circulatory Death
title Transesophageal Echocardiography Guidance to Prevent and Manage Pitfalls from Abdominal Normothermic Regional Perfusion and Optimize Timing during Organ Retrieval from a Donor after Circulatory Death
title_full Transesophageal Echocardiography Guidance to Prevent and Manage Pitfalls from Abdominal Normothermic Regional Perfusion and Optimize Timing during Organ Retrieval from a Donor after Circulatory Death
title_fullStr Transesophageal Echocardiography Guidance to Prevent and Manage Pitfalls from Abdominal Normothermic Regional Perfusion and Optimize Timing during Organ Retrieval from a Donor after Circulatory Death
title_full_unstemmed Transesophageal Echocardiography Guidance to Prevent and Manage Pitfalls from Abdominal Normothermic Regional Perfusion and Optimize Timing during Organ Retrieval from a Donor after Circulatory Death
title_short Transesophageal Echocardiography Guidance to Prevent and Manage Pitfalls from Abdominal Normothermic Regional Perfusion and Optimize Timing during Organ Retrieval from a Donor after Circulatory Death
title_sort transesophageal echocardiography guidance to prevent and manage pitfalls from abdominal normothermic regional perfusion and optimize timing during organ retrieval from a donor after circulatory death
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381753/
https://www.ncbi.nlm.nih.gov/pubmed/37511790
http://dx.doi.org/10.3390/jpm13071177
work_keys_str_mv AT bianchiniamedeo transesophagealechocardiographyguidancetopreventandmanagepitfallsfromabdominalnormothermicregionalperfusionandoptimizetimingduringorganretrievalfromadonoraftercirculatorydeath
AT laicicristiana transesophagealechocardiographyguidancetopreventandmanagepitfallsfromabdominalnormothermicregionalperfusionandoptimizetimingduringorganretrievalfromadonoraftercirculatorydeath
AT miglioniconoemi transesophagealechocardiographyguidancetopreventandmanagepitfallsfromabdominalnormothermicregionalperfusionandoptimizetimingduringorganretrievalfromadonoraftercirculatorydeath
AT bianchimariagiacinta transesophagealechocardiographyguidancetopreventandmanagepitfallsfromabdominalnormothermicregionalperfusionandoptimizetimingduringorganretrievalfromadonoraftercirculatorydeath
AT tarozzielena transesophagealechocardiographyguidancetopreventandmanagepitfallsfromabdominalnormothermicregionalperfusionandoptimizetimingduringorganretrievalfromadonoraftercirculatorydeath
AT bernardienrico transesophagealechocardiographyguidancetopreventandmanagepitfallsfromabdominalnormothermicregionalperfusionandoptimizetimingduringorganretrievalfromadonoraftercirculatorydeath
AT tonijessica transesophagealechocardiographyguidancetopreventandmanagepitfallsfromabdominalnormothermicregionalperfusionandoptimizetimingduringorganretrievalfromadonoraftercirculatorydeath
AT cordellaerika transesophagealechocardiographyguidancetopreventandmanagepitfallsfromabdominalnormothermicregionalperfusionandoptimizetimingduringorganretrievalfromadonoraftercirculatorydeath
AT vitalegiovanni transesophagealechocardiographyguidancetopreventandmanagepitfallsfromabdominalnormothermicregionalperfusionandoptimizetimingduringorganretrievalfromadonoraftercirculatorydeath
AT siniscalchiantonio transesophagealechocardiographyguidancetopreventandmanagepitfallsfromabdominalnormothermicregionalperfusionandoptimizetimingduringorganretrievalfromadonoraftercirculatorydeath